WIFS New Member Application

Please complete the membership form below for National and Chapter membership.

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.

National Dues *

National Dues (Full Rate) - $ 281.67

Local Chapter *

Please renew my membership automatically.

Total Amount

Email Address *

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 *

Primary Motivation for Joining

How Did You Hear About WIFS? *

Agreement *

I acknowledge WIFS membership dues are nontransferable and nonrefundable. The dues paid will reflect current membership for myself only through December 31.

Credit Card Information

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 "Submit Application" 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.

WIFS New Member Application

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