Membership form

Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Cell Phone
Email
Meditation instructor
If you have a meditation instructor let us know who it is, or who you would like it to be.
Volunteer Interests
I would like to pay monthly dues online.
If you choose "Yes," you can pay dues online via a monthly subscription. Select the amount below and click the Submit button. This will take you to PayPal where you can sign up to pay monthly with a PayPal account or a credit card. If you choose "No," our membership coordinator will contact you to arrange payment.
I would like to pay monthly*
- $15.00
- $25.00
- $35.00
- $50.00
- $75.00
- other amount
I would like to pay this amount monthly:
Total
$0.00
Additional information
Privacy*
- By using this form you agree with the storage and handling of your data by this website.