Family Membership
Please complete this form to register. After, please ensure you follow through to PayPal to complete this transaction. Until you have paid for your membership, your membership is NOT active. Any major credit card is accepted - no PayPal account needed.
* Required
Email address
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Your email
Card Holder #1 First Name
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Your answer
Card Holder #1 Last Name
*
Your answer
Card Holder #2 First Name
Your answer
Card Holder #2 Last Name
Your answer
Address
*
Your answer
Postal Code
*
Your answer
Phone Number
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Your answer
Are you a new or existing member renewing your membership with DQCA? (New or Renewal. If renewal, please add existing membership number)
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Your answer
Do you want to get email updates from the community?
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Yes
No
Do you want to hear about volunteer opportunities?
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Yes
No
How did you hear about the DQCA?
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Your answer
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