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  • Individual/Couple Membership For 3 Years


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Spouse's Name (if joining as a couple)::

The lodge/unit you wish to join (if you aren't joining a specific group, we will place you in the Member At Large group for your region)::

Spouse's Name (if joining as a couple):
The lodge/unit you wish to join (if you aren't joining a specific group, we will place you in the Member At Large group for your region):

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Card Security Code
The card security code is a unique three or four digit number, separate from your credit card number. Your security code can be found in the following locations on the following cards:
Visa/MasterCard/Discover
Your card security code for your MasterCard, Visa or Discover card is a three-digit number on the back of your credit card, immediately following your main card number.
Visa Card
American Express
The card security code for your American Express card is a four-digit number located on the front of your credit card, to the right of your main credit card number.
Visa Card
If your security code is missing or illegible, please call the bank or credit card establishment referenced on your card for assistance.

If this is a gift membership, please complete the following fields:

Member's Name::

Spouse's Name (if applicable)::

Address::

City/State/Zip::

Member's Email Address::

Member's Name:
Address:
Member's Email Address:
Spouse's Name (if applicable):
City/State/Zip: