Wayne America General Member Application

Instructions

Welcome to Wayne America! We are excited to have you join us.

Select An Option

5 Star

$2000+

4 Star

$1500

3 Star

$1000

2 Star

$500

1 Star

$400

Individual

$200

Non-Profit

$100

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameBusiness Name

Please select a valid membership option and fee item if exist

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