Junior New Membership

Use this form only if the child is joining as a new Junior Society member; must be age 19 or younger. On-line applications for Junior Memberships can only be accepted from parents or guardians.

There is currently only one level of Junior membership:
Classic: Benefit - Porcelain Pin
Choice or Premier membership is not available at this time.

Junior Membership Level                                                                          

Classic: $25, Benefit: Porcelain pin

 
Credit Card or Check Holder's Information:
Name:
Address:
City:
State:
Zip:
Country:
Phone #:
Email Address:
Enter New Member's Information Here:
Name:
Address:
City:
State:
Zip:
Country:
Junior Member's Birth Date:
If a Society Member has recruited you enter their Membership Number or Name below. Or if you are a member signing up a new member please enter your membership number below. The recruiter will receive a voucher good for $5.00 off their next renewal:
Membership Number or Name to Receive Voucher:
Choose One:
$28.00 Classic One Year (Benefit: Porcelain Brooch)
Notes: