| Membership
Categories (Please select one.) * |
| |
$50
|
| Billing Information
(As it appears on your credit card and statement.) |
| E-mail |
(For confirmation by e-mail.) |
| Expires |
/
(Month / Year) * |
| CVV |
(Click
here for CVV info.) * |
| Postal Mail |
Please add me to your postal mailing list. |
| E-mail |
Please add me to your e-mail mailing list. |
| Volunteer |
I would like to volunteer for DrUMM efforts. |
Submission of this form authorizes DrUMM
to charge the
cardholder of the credit card furnished for applicable fees
as outlined in this form. Please ensure that you click
on
the "Submit" button ONCE; otherwise, multiple charges
may be processed. |
