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Some Information We Need About You

Is this a GIFT membership? If so, please answer the remaining questions on behalf of the recipient.:

Are you joining INPAWS or renewing your membership?:

In which Indiana county do you reside? If in a county bordering Indiana, please enter the Indiana county closest to you. This will help us assign you to the proper INPAWS chapter.:

Enter your name and that of your spouse or partner as you wish them to appear in the Membership Directory, and optional business name. Groups please enter organization name and principal contact name.:

If this is a GIFT Membership, please provide the address of the recipient.:

Preferred phone contact:

Preferred email address:

Website of your business or organization (optional).:

Is this a GIFT membership? If so, please answer the remaining questions on behalf of the recipient.
In which Indiana county do you reside? If in a county bordering Indiana, please enter the Indiana county closest to you. This will help us assign you to the proper INPAWS chapter.
If this is a GIFT Membership, please provide the address of the recipient.
Preferred email address
Are you joining INPAWS or renewing your membership?
Enter your name and that of your spouse or partner as you wish them to appear in the Membership Directory, and optional business name. Groups please enter organization name and principal contact name.
Preferred phone contact
Website of your business or organization (optional).
Required

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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.

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