Membership Renewal

*Business Name

*Contact Name

*Address

*City/Town

*Postal Code

*Phone (Business)

Phone (Home)

Phone (Toll-free)

Fax

*E-mail

Website

Describe the product/services that you offer, and the months that they are available.

*Website Listing OK as is

  I will email changes

*Lap Map Listing OK as is

  I will email changes

  Full Membership Fee @ $100.00

Add 012345 extra lap map listing(s) @ $20.00

Add 01 extra website listing(s) @ $50.00

  Pay now with Paypal

  Sending Cheque

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