Membership

First name

Last name

Birthdate (Month and Day Only)

Email

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Country of Residence

Membership Type

Membership

Volunteer

What specific skill(s) you will bring to the organization? (Choose Any Two)

Medical

Education

Fund Raising (Events & Grant Writing)

Legal (Editing & Compliance)

How did you hear about us?

Why are you interested in joining our association?

Do you have any special skills or interests you would like to contribute as a member?

Any other comments or questions?

Membership Dues

Yearly Payment$200

Quarterly Payment $50

Monthly$17

Declaration: I certify that all information provided in this application is true and accurate to the best of my knowledge. I understand that membership approval is at the discretion of the association and may be subject to review.

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OYS Membership Application