Application for Membership Membership Application Form Is this a new application or a renewal?*New ApplicationRenewalName* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Address* Street Address Address Line 2 City State / Territory Postal Code Mobile Phone NumberIf applicableHome Phone NumberIf applicableEmail Address Membership Type*Annual Membership ($30)Life Membership ($250)Select a membership type from the options belowWould you also like to make a donate to DHOT?NoYesTerms and PaymentAll 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*Please provide your signature using your mouse, or finger on a touch-enabled device.Credit Card Card Details Cardholder Name Total Due Today $ 0.00 Once you submit your membership application, you will be automatically redirected to our donation page. All fields will be prefilled with the exception of your credit card.Once you submit your membership renewal, you will be automatically redirected to our donation page. All fields will be prefilled with the exception of your credit card.