Special Membership Application Form

Name:
Spouse's name:
Address:
City:
State:
Zip/Postal code:
Country (if not US or Canada):
Daytime phone:
Evening phone:
Fax phone:
Mobile (cell) phone:
E-Mail:
IMPORTANT: List your full E-Mail Address ie: JohnPublic@AOL.com  

Please tell us how
you heard about the
Four Freshmen Society 

Concert:   Friend told me:        Printed publication:
Online:    Car window sticker:

Other or Comments:

      Dues structure:         Single/family new member dues: $15.00

        Choose your membership application type by clicking the down-arrow below:

        The Four Freshmen Society can accept dues payment via Visa or MasterCard as well as by check or money order.

        Choose how you would you like to pay by clicking the down-arrow below:

        If you checked one of the credit cards above, please enter your card number, expiration date and CVV code below:

        Name on card:
        Card number: ---
        Expires (mm/yy):    /
        CVV code ( What's this?):   

        NOTE: If you don't wish to pay online, or if you wish to pay by check or money order, just click HERE to print this form.  Make out your check or money order to "The Four Freshmen Society" and mail to:

        Four Freshmen Society
        Membership Department
        6900 Hunters Knls NE
        Atlanta, GA 30328-1763

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    Click the "SUBMIT" button below to submit this form.

    If you have any problems submitting your Registration Form, click to email us about your problem.

    Note: If, after you press the "SUBMIT" button, you don't get a screen letting you know
    that your Application Form has been successfuly sent, fix the indicated errors and try again.