Membership Dues Date MM slash DD slash YYYY Name(Required) First Last Email(Required) Membership type(Required) Individual Household Would you also like to add a donation? Yes No Contribution For: General Club Operations Event / Match Hospitality Trophy Fund Other Donation Amount Payment type(Required)PayPal allows credit card payments. $1.50 added for processing fees. PayPal Mail a check Total Payment MethodPayPal Checkout MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name Mail check payable to Welsh Terrier Club of Northern Illinois and mail to Michele Foley 1388 W. Timber Trail Dr. Whitehall, MI 49461
