WIFS Membership Application (Monthly)

Please complete the membership form below for national and chapter membership.

Read all instructions carefully.

WIFS Membership: Monthly - National+Local Chapter

Use this form to sign up for National and Chapter dues, payable on an automated, monthly renewal basis.

By completing this form I acknowledge that I have chosen to pay my WIFS membership dues in monthly installments, and I authorize WIFS to charge my credit card each month for the amount of my full or (if applicable) prorated dues divided by the months remaining in the membership year. I further acknowledge I will not receive a refund (full or partial) of any dues already charged to my card should I choose to cancel my membership before the end of the year.

Please choose your Local Chapter below. If you are not joining a Chapter, select Member-at-Large. National and Chapter dues will be charged when your membership is submitted.

National Dues *

Monthly National Dues (Full Rate) - $ 22.00

Local Chapter *

Please renew my membership automatically.

Total Amount

If paying by credit card, a transaction fee will be automatically added to the total amount.

Email Address *

Account

Please enter a Username to create an account. If you already have an account please login before completing this form.

Username *

Check Availability
Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.

Password

Confirm Password

Provide a password for the new account in both fields.

WIFS Membership Application

Partner Affiliation *

Prefix

First Name *

Middle Initial

Last Name *

Informal Name

Title

Website

Organization

Business Street Address *

Business City *

Business Country

Business State *

Business Zip Code *

Home Street Address *

Home City *

Home Country

Home State *

Home Zip Code *

Work Phone *

Cell Phone *

Include me in membership directories? *

Yes No

Primary Motivation for Joining

How Did You Hear About WIFS? *

What other association(s) are you a member of? *

Mailing List Subscriptions

LeadHER Blog

Agreement *

I acknowledge WIFS membership dues are nontransferable and nonrefundable. The dues paid will reflect my current membership exactly one year from the day my membership became active.

Authorize.net (Credit Card)

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

Please click the "Review Your Contribution" button only once.

It may take a moment for the form to process. If you click it twice, you may be double charged.

Also, please note: it may take up to 24 hours for your membership to process - you may not be able to log onto the site immediately.