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PayPal Membership Signup Application
Annual Membership Cost (Jan- Dec): Youth = $5, Adult (21+) = $20, Family = $25
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* Indicates required question
First Name & Last Name (Primary Member)
*
Your answer
Street Address:
*
Your answer
City:
*
Your answer
State:
*
Your answer
Zip Code:
*
Your answer
Birthdate:
*
MM
/
DD
/
YYYY
NAR Membership Number:
Your answer
Tripoli Membership Number:
Your answer
High Power Certification Level:
*
(None = 0) Level 1, 2, or 3
0
1
2
3
Cell Phone Number:
*
xxx-xxx-xxxx
Your answer
Join Woosh Google Email Group?
*
Yes
No
Family Member (Spouse)
Provide First & Last Name | Birthdate | NAR and/or TRA # | Cert Level
Your answer
Family Member Child # 1
Provide First & Last Name | Birthdate | NAR and/or TRA # | Cert Level
Your answer
Family Member Child # 2
Provide First & Last Name | Birthdate | NAR and/or TRA # | Cert Level
Your answer
Family Member Child # 3
Provide First & Last Name | Birthdate | NAR and/or TRA # | Cert Level
Your answer
Family Member Child # 4
Provide First & Last Name | Birthdate | NAR and/or TRA # | Cert Level
Your answer
Family Member Child # 5
Provide First & Last Name | Birthdate | NAR and/or TRA # | Cert Level
Your answer
Family Member Child # 6
Provide First & Last Name | Birthdate | NAR and/or TRA # | Cert Level
Your answer
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