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Membership Application

From Dunham-Singletary Family Connections
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(Select your Membership Support Level - Note: This section is being Updated)
 
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==Select your Membership Support Level - Note: This section is being Updated==
  
 
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{| style="background:#ffffff;color:black;width:80%;" border="1" cellpadding="5" cellspacing="10"   
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| style="background:#FFE4B5;color:black;width:25%;" align="center" |  DGRA Member - $25.00 || style="background:#deb887;color:black;width:25%;"  align="center"  | Bronze Membership - $50.00 || style="background:#C0C0C0;color:black;width:25%;" align="center" | Silver Membership - $75.00 || style="background:#ffd700;color:black;width:25%;" align="center" | Gold Membership - $100.00
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|}
 
<emailform>
 
<emailform>
 
  {|  
 
  {|  
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  | City: || <emailform city=40 />  
 
  | City: || <emailform city=40 />  
 
  |-
 
  |-
  | State: || <emailform state=40 />  
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  | State/Province: || <emailform state=40 />  
 
  |-
 
  |-
  | Zip/Postal Code: || <emailform zip=10 />  
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  | Zip/Postal Code: || <emailform zip=40 />  
 
  |-
 
  |-
 
  | Country: || <emailform country=40 />
 
  | Country: || <emailform country=40 />
  |-  
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  |-
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| Phone Number : || <emailform phone=40 />
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|- 
 
  | Email: || <emailform email=40 />  
 
  | Email: || <emailform email=40 />  
 
  |-
 
  |-
 
  | Website: || <emailform website=40 /> || (optional)
 
  | Website: || <emailform website=40 /> || (optional)
 
  |-
 
  |-
 
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  | Comments:  
  | Comments:
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  | colspan="2" | <emailform comments=80x8 />
 
  | colspan="2" | <emailform comments=80x8 />
 
  |-
 
  |-
 
  | colspan="3" align="center" | <emailform submit="Submit Application" />
 
  | colspan="3" align="center" | <emailform submit="Submit Application" />
 
  |}
 
  |}
  </emailform>
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  </emailform>  
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'''The Annual Membership Support begins at $25.00'''.  After you click on "''Submit Application''" you will be prompted to click on a paypal "add to cart" button to complete your membership renewal.
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  Thank you for your membership.
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  Your information has been transmitted; Please complete payment for your Membership via PayPal by clicking on the add to cart button below.
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  To pay for Bronze, Silver or Gold you can use multiples of $25.00 or send a check at this time.  If you have questions please use the Contact Us
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  button under Navigation to the left - Attn: DGRA Treasurer.
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<emailform result>
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<html>
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  <emailform result>
 
  <emailform result>
 
  Thanks for your registration.  
 
  Thanks for your registration.  
  
Please complete your registration by clicking on the add to cart button.
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  Your information has been transmitted; Please complete payment for membership  via PayPal by clicking on the add to cart button.
  
  
 
<html>
 
<html>
  
<form target="paypal" action="https://www.paypal.com/cgi-bin/webscr"
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<form target="paypal" action="https://www.paypal.com/cgi-bin/webscr" method="post">
 
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method="post">
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<input type="hidden" name="cmd" value="_s-xclick">
 
<input type="hidden" name="cmd" value="_s-xclick">
 
<input type="hidden" name="hosted_button_id" value="W3D6A9HPVGPFL">
 
<input type="hidden" name="hosted_button_id" value="W3D6A9HPVGPFL">
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height="1">
 
height="1">
 
</form>
 
</form>
 
 
</html>
 
</html>
 
 
  </emailform>
 
  </emailform>

Latest revision as of 20:51, 13 January 2021

[edit] Select your Membership Support Level - Note: This section is being Updated

DGRA Member - $25.00 Bronze Membership - $50.00 Silver Membership - $75.00 Gold Membership - $100.00

Full Name:
Street Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone Number :
Email:
Website: (optional)
Comments:
 

The Annual Membership Support begins at $25.00. After you click on "Submit Application" you will be prompted to click on a paypal "add to cart" button to complete your membership renewal.


 Thank you for your membership. 
 Your information has been transmitted; Please complete payment for your Membership via PayPal by clicking on the add to cart button below.
 To pay for Bronze, Silver or Gold you can use multiples of $25.00 or send a check at this time.  If you have questions please use the Contact Us
 button under Navigation to the left - Attn: DGRA Treasurer.
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