Online Convention Registration

Name *

First

Last

Phone *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Section A: Join Us! (if not currently a member or expired) *

Dual membership please add second name here(must be same address) *

First

Last

Section B: Members Only Convention Package *

Bloomfield Hills(Detroit)-MI- 2025

Second Member's Name *

First

Last

Second Member's Phone # *

Welcome Reception(Select Yes if attending) *

Volunteer Activities(I can help with):

Comments or Questions

Total

$0.00

Stripe Credit Card *

Card

Name on Card