To send this application with your membership fee
Highlight, copy, paste, complete, print, sign and return the application below.
How do I do that?
  pdf Version   Click close to return.


Application for Special Project Action Planning Membership

Name(s)
1 2
Street
 
City
 
Zip
 
Home #
 
Work# 1
 
Work # 2
 
Email #1
 
Email #2
 
What have you learned about Chimorel thus far? What is your intention?
[x] Significant Problem/Major Goal    [] Altruistic     Please explain

 

 

Who told you about Chimorel?
 
Action Planning Annual Membership   (Cash Paid)

$150

{x}My/our intention: initiate a Chimorel Special Project.
Please consider this application as my/our request to initiate a
special project.
 
() My intention is altruistic(please tell us more above)  

       For your convenience we have checked {x} initiate a Chimorel Special Project. We anticipate you will choose to solve significant problem or achieve a major goal of your own. We will contact you to initiate your Special Project. Please pay attention to emails to the address(es) provided.
        If you want this application to be altruistic, change {x} to {} and () to (x). You will have one more chance to change your intention from initiate a Special Project to Altruistic when you receive your Confirmation email.

       
Your Cash Paid Action Planning Membership entitles you to initiate a first level Chimorel Special Project. You will receive the first chapter of Create a Chimorel Project as part of your confirmation email. You will be able you to download all ten chapters.
       Be sure to register and confirm your membership when you receive our confirmation email. Registering and confirming starts your Success Journey with Chimorel. You will learn a lot. You can help others.

Send your $150 check with this application to:

        Do not give your membership fee to another member or to a Resource Developer. Send it to the address above or give it to the registration person at a Chimorel event or Cooperative Effort meeting. We have set up this procedure for your protection. Click close.
       
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 1 ___________________________________ Signed 2 ______________________________________ Date ___/___/11
Become a Voting Member  Click close to return.

© The Chimorel Group 2006