Membership Forms

Membership Change Request Form

Add or remove a dependent on your membership. Complete the form online, then download a signed PDF copy that is also emailed to our committee.

Main Applicant Information

Main Applicant Name

Membership ID

Email (for your confirmation copy)

Date Submitted

Request Type

Please select one.

What change are you requesting?

Note: A dependent who has reached 25 years of age or older is no longer eligible to remain under the main applicant's membership. The dependent must submit a new membership application in their own name.

Declaration

I certify that the information provided on this form is true and complete. I understand that any dependent who has reached 25 years of age or older must submit a separate membership application in their own name.

I have read and agree to the declaration above.

Main Applicant Signature (type full name)

Date

Submitting downloads a signed PDF and emails it to our committee.