Name:* (Use same name you will be using for
payment so we can match them up)
 

Email:*
 

Address:*
 

Phone:
 

City:*
 

State:*
Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

If Billing Name is Different Than Membership
Name Please List Below:
 

Zip:*

Desired Membership:*
Please Select Regular Individual - $25 Regular Family - $40 Friend of Dunesland - $100 Lifetime - $1500 Full Time Student - $15 Senior (Over 65 Upon Request) - $20

Membership is subject to board approval at the next scheduled board meeting.