Photo of CDR Members with ADA Bus

Membership Application - Web Form

Please fill in all information
NOTE:  Payment instructions will follow after submitting your online application.

Name:
Street Address, Apt #:
City:
State:
Zip Code + 4: -
Telephone:
E-mail Address:
New or Renewal: New     Renewal
Payment Options: Submit through mail     Submit through PayPal
*Payment instructions will follow after submitting your application.
Membership Fee Amount: Use the following to calculate your dues:
Regular Dues: $25.00
Student/Low Income Dues: $10.00
Family (2 people) Dues: $40.00
Lifetime Membership: $200.00
Total Membership Fees $   *Please jot down amount to be submitted!
 Please put me on the CDR Members Exchange via Yahoo Groups (must supply e-mail address)
Questions/Comments: