Membership Application
Please complete all FOUR sections of this application. You will see a confirmation screen when you have finished the entire application. If you have questions as you complete it, please contact Gino Satriana, our Executive VP at (505) 264-2130 or
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Full Name *
Year of Birth *
Mailing Address *
Preferred phone number *
Home Email Address *
School Worksite *
Position *
LAST FOUR of Social Security Number (Required for payroll deduction) *
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