Pine Tree Guide Dog Users Membership Renewal Form

Thank you for your interest in renewing your membership with PTGDU.

Annual Dues: $20 for access from January 1 thru December 31.

If you choose to send us a check, please make it payable to Pine Tree Guide Dog Users, and mail the check to P.O. Box 6157, Falmouth, ME 04105. Be sure to include your name and address as entered on this form.

You are only required to fill out your name and email address, then move directly to the payment method field if none of your other information has changed.

PTGDU Registration Membership Renewal Form

Name

First

Last

Email Address

Street Address

Apartment, Suite, etc.

City

State or Province

Zip or Postal Code

Country

Primary Phone Number with Area Code

Secondary Phone Number with Area Code

You can pay with PayPal, credit or debit card, or by check. Please indicate which method you will use. When you click the RENEW NOW button, you will be redirected to a payment page. Thank you!

PayPal

Credit Card

Debit Card

Check (You will be shown the mailing address.)

Other Personal Information

If you are human, leave this field blank.