WIP Membership Registration and Renewal Form

Thank you for your interest in WiP! Please use this form to join or renew your membership in WiP. This page does not process any payment transactions. It only records membership information. Once you have completed the form, please click "Pay Now" to make your payment using PayPal. You do not need to have an account with PayPal to use this service. You can also mail your payment with a check to Women in Philanthropy, PO Box 224, Northampton, MA 01061-0224.

WiP's membership year runs September 1 to August 31. We are not able to pro-rate the membership fees for partial years so to get the best value, join early!

	MEMBER INFORMATION
*	Name:
	Title:
	Organization:
	Address:
	City:
	State:
	Zip:
	Phone:
*	Email:

	PURCHASER INFORMATION (only if different from above)
	Name:
	Title:
	Organization:
	Address:
	City:
	State:
	Zip:
	Phone:
	Email:

	MEMBERSHIP FEE
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	Details about the 2012-2013 membership categories can be found here

	HOW WILL YOU MAKE PAYMENT?
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