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Membership and Subscription Form

One person per form, please. We have a paper version of the form but we strongly prefer you submit the one below because it makes processing faster and more accurate.

Note: If you are under 18, you must also have a parent/guardian notarized signature on this waiver. If you are renewing a membership/subscription, or rejoining after your membership expired, please use the renewal form instead.

Personal Information				Privacy Level
Secular name:	(help)			(help)
Religious name:	(help)
Address:
City:		State/Prov.:
Zip/postal code:		Nation:
Birth date:	(help)	Phone:
E-mail address:
Grove affiliation:	(help)
Where did you hear about us?			Specifically:
Note: As stated in our privacy policy, ADF will not sell or rent your personal information.

Donations
Membership donation		years
Oak Leaves journal (help)		years
Additional donation (help)		$
(All funds are in U.S. dollars)	Total Due:	$

Payment Options
Payment Method:	Credit Card (PayPal)	Check or Money Order

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