WIFS Member Application

Read all instructions carefully.

WIFS Membership - National+Local Chapter

Please choose your Local Chapter below. If you are not joining a Chapter, select Member-at-Large.

If you have a discount code, enter it here

National Dues *

National Dues (Full Rate) - $ 260.00

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.

Supported browsers include Chrome, Firefox, Internet Explorer 11, and Safari and work best with the latest versions.

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

Please note: It may take up to 24 hours for your membership to process and you may not be able to login to the Member Website immediately.