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* Create Login Name
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* First Name
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* Address Line 1
Address Line 2
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* Membership Young Professional - $40 (40 and younger)
Young Professional (under 40) - $40
Supporter - $60
Contributor - $100
Patron - $250
Benefactor - $500

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If you are purchasing this membership as a gift, please provide the name and email address of the new member:

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The membership you have selected will automatically renew.
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