Membership Application

(All information is kept strictly confidential)

Please read the instructions below carefully!!! Thank you!

You now have 3 ways of paying for your BTS Membership.

#1 To pay online via PayPal: Please complete the on-line application
below and click the "Buy Now" link on the confirmation page.

#2 To pay via Check or Credit Card: Please download and print the
membership application.

First Name*:

Last Name*:

Address*:

City*:

State*:

Zip*:

Date of Birth*:

Marital Status*:

Married
Single
Widowed

Phone*:

Fax:

E-Mail*:

Would you be interested in becoming a BTS Chapter Director in your area*:

Yes
No

If yes, please provide the City and State

Are you part of a BTS Chapter*:

Yes
No

If yes, what is the Chapter Director's name?

If applicable, what is the name of the Chapter?

How were you referred to BTS*?:

Membership Payment Information

Dues are a 1-time Lifetime $50 Membership. Your Membership becomes effective upon receipt. You will have a 30-day cancellation period after the date of the application for a full refund.