HTML5 / CSS3 Responsive Page
 

Membership Application Form

New/Renewal: *   * = Required Field
 
Chapter Affiliation: *
Membership Type: *
Membership Level: *
 
Prefix: *
First Name: * Last Name: *
Street Address:
*
City: * State: *
Zip: * County: *
Occupation: D.O.B.: *
Daytime Phone: Evening Phone: *
Email Address: *
Your Comments:
BY SUBMITTING THIS MEMBERSHIP APPLICATION, THE APPLICANT AGREES TO HIS/HER DUTIES AS A MEMBER, TO CONDUCT HIMSELF/HERSELF SO AS TO CONFORM WITH THE BYLAWS OF TGRA, INC. AND ANY RULES AND REGULATIONS DULY AND VALIDLY ADOPTED BY THE DIRECTORS, THE OFFICERS, ANY COMMITTIES OR THE MEMBERSHIP OF TGRA INC. THE APPLICANT FURTHER AGREES IN CONNECTION WITH HIS/HER PARTICIPATION OR ATTENDANCE IN/AT ANY EVENT HELD BY OR FOR THE BENEFIT OF TGRA INC. TO ALWAYS COMPLY WITH ALL APPLICABLE LAWS AND SHALL HOLD HARMLESS TGRA INC. FROM ANY AND ALL DAMAGE, INJURY OR DEATH WHICH MIGHT OCCUR TO THE UNDERSIGNED OR THE APPLICANT'S PROPERTY BEFORE, DURING OR AFTER ANY FUNCTION INVOLVING TGRA INC. FAILURE TO HONOR THE COMMITMENTS SET FORTH ABOVE, OR TO PAY DUES, MAY RESULT IN TERMINATION OF MEMBERSHIP. I FURTHER HEARBY CERTIFY THAT I AM 18 YEARS OF AGE OR OLDER.

By clicking the Send Form button, your membership application will be submitted, and you will be directed to the PayPal site to process payment of dues.
PayPal Acceptance Mark