To send this application with your membership fee
Highlight, copy, paste, complete, print, sign and return the application below or use the pdf version.
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Application for Starter Membership

Name
 
If you are married,
ask your spouse to complete a separate Starter application or
go directly to our Cash Paid Action Planner application.

Street
 
City
 
Zip
 
Home #
 
Work#
 
Cell #
 
Email #1
 
Email #2
 
What have you learned about Chimorel thus far? Do you have any questions?

 

 

Who told you about Chimorel?
 
Starter Annual Membership      

$50

[x] Turn my Starter Membership into an Action Planning Membership

$50 + 10-20 hours
[x] My intention is altruistic.
I will set my goal using the Set Goal area of the website.
 
() I/we need help setting my goal. Please contact me.  

       For your convenience we have checked [x] Turn my Starter membership into an Action Planning membership for you. This makes you an Action Planner immediately. You can complete your 10-20 volunteer hours any time during the next year. We will give you many ways to do so. To initiate your Special Project, you want to become a Cash Paid Action Planner.
       Being altruistic means part of your application fee can help others; however, if you need help setting your goal, change {x} to {} and () to (x). You will have one more chance to change your intention from Altruistic to Assistance when you receive your Confirmation email.
       Be sure to register and confirm your membership when you receive our confirmation email. Registering and confirming starts your free Success Journey with Chimorel. You will learn a lot. You can help others.

Send your $50 check with this application to:

       Do not give your membership fee to another member or to a Resource Developer. Send it to our address above or give it the registration person at a Chimorel event or Cooperative Effort meeting. We have set up this procedure for your protection..
      You will receive an email confirming your membership and explaining your membership benefits in greater detail. If you want to become a voting member complete the voting application on the next screen and return both applications with your check to the address above.
       Thank you!

Signed _______________________________________________________ Date ___/___/11
Become a Voting Member Click Close to return

© The Chimorel Group 2006