Application for Membership

Is this a new application or a renewal?*
Name*
Prefix First Last
Address*
Street Address Address Line 2 City State / Territory Postal Code
Mobile Phone Number
If applicable
Home Phone Number
If applicable
Email Address
Type of Membership*
Annual Membership is $50 P/Y While a lifetime membership is $500.
- Annual Membership
- Life Membership
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Annual Membership
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Life Membership
Additional donation

If you would also like to make an additional donation today, please enter amount here.
Terms and Payment
All new applications are considered by the TCDL Board at the next scheduled monthly meeting. You will be issued with a letter stating the outcome of your application following the board meeting. I understand the TCDL has the right to refuse this application for membership and refund my subscription.
Signature*
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Credit Card
Card Details
Cardholder Name
Total Due Today
$ 0.00

Terms and Payment