IFloss
 



IFLOSS Membership Application


Please fill out the following information to apply for membership in IFLOSS.

After you fill out the form and click Submit, you will be taken to a confirmation page that you may print out and send with a check, or pay immediately with the Paypal "Pay Now" button.

If you prefer, you may register by mail by clicking here and printing out the form.



Name:


Organization:

Street Address:
  City, State, Zip:



Phone:

FAX:

Email Address:

Payment Options:

Student$10
Individual$30
Affiliate (organizations)$50
Sustaining (organizations)  $1000
Lifetime Individual$250


Additional Information:
 




 


Cancel application and return to IFLOSS website