Membership Application

Today's Date*

Name*

First Last

Primary Email*

Is your Primary Email address Work or Personal? (select one)*

Work
Personal

Alternate Email

NOTE: Alternate email address used if we receive a bounce back from your primary email address.

Is your Alternate Email address Work or Personal? (select one)

Work
Personal

Preferred Phone Number*

Fax Number

Job Title

Organization*

Organization or Personal Physical Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Select which type of membership you are interested in*

Individual New Membership ($50 per year annually)
Individual Renewing Member ($25 per year annually)
Group/Corporate New Membership $100 per year (Jan-Dec) for up to 4 individuals
Group/Corporate Renewing Membership $50 per year (Jan-Dec) for up to 4 individuals
I would like to make an additional donation

Membership Payment*

Payment mailed to North Texas ILG at 513 S. Tennessee St, McKinney, TX 75069
Pay online at https://ntilg.org/payment/

May we contact you about having your Company host one of our meetings? (select one)*

Yes
No

Website Credentials Confidentiality Agreement*

I agree not to share my NTILG.org login credentials with colleagues to access NTILG recordings and speaker presentations which are benefits exclusive to paying NTILG members.

I agree to the policy.

Comments

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Membership Application

NTILG Membership Application