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:
Oranization:
Street Address:
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Phone:
FAX:
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Payment Options:	Student $10 Individual $30 Affiliate (organizations) $50 Sustaining (organizations)   $1000 Lifetime Individual $250
Additional Information: