2024-2025 Non-Riding Membership

I have read and agree to the member agreement. *

Signature *

First Name *enter member first name

Last Name *

Phone *

Street Address *

City *

State * AL - AlabamaAK - AlaskaAZ - ArizonaAR - ArkansasCA - CaliforniaCO - ColoradoCT - ConnecticutDE - DelawareDC - District of ColumbiaFL - FloridaGA - GeorgiaHI - HawaiiID - IdahoIL - IllinoisIN - IndianaIA - IowaKS - KansasKY - KentuckyLA - LouisianaME - MaineMD - MarylandMA - MassachusettsMI - MichiganMN - MinnesotaMS - MississippiMO - MissouriMT - MontanaNE - NebraskaNV - NevadaNH - New HampshireNJ - New JerseyNM - New MexicoNY - New YorkNC - North CarolinaND - North DakotaOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVT - VermontVA - VirginiaWA - WashingtonWV - West VirginiaWI - WisconsinWY - Wyoming

Zip Code *

Date of Birth *

Email Address *

I am sponsored by a current Mystical Order of the Phoenix member * Yes No

Sponsoring member's name (optional)

I would like to be assigned to the following Float Lieutanant's float (choose one): * Kara BoraschSelina BooneKaren BoudrieCarla CatalanoAlison FrasierDawn FrickChanel LabatMickey MiltonKristin RichGigi SaakCaitlin StrotherKelli WrightI don't know/Doesn't matter

I would like to be considered for a Riding Member position for 2024-2025, should they become available * Yes No

Are you a new or returning member? * New member Returning Member (from last year)