New VIKPA membership form

VIKPA has a new updated Membership form, it is posted here and also you can find it here on the membership page

VIKPA Membership Form

May we call you about volunteering?
YesNo
Main Membership $10 Membership for one person
My Name Your first and last name
Email
Phone
Today's Date
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Additional family member at $10 each

Family Member
Their Name Family member's first and last name
Their Email
Their Phone
May we call you about volunteering?

Your Donation

I would like to make a donation of Enter numbers only
TOTAL amount to be submitted on PayPal Enter numbers only. Memberships + Donation Please enter the total amount here and on the PAYPAL page.

Other Info

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Verification

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