New Member Sign-Up

Individual membership: $35

Agency membership: $175

Sponsoring organization/corporation: $500

Supporting individual: $100

Please submit this online form and then mail your check to:
SDNAFV&SA
300 N. Dakota Ave., suite 112
Sioux Falls, SD 57104

First Name		Last Name
Organization (if applicable)
Address		City
State		Zip
Daytime Phone		FAX
E-mail Address
How did you hear about us?     Please select one... Online Yellow Pages Search Engine SD Network Member SD Network Employee Phone Book Friend or Acquaintance
Membership Type     Please select one... Individual Agency Sponsoring Org./Corp. Supporting Individual
Message
Enter the word from the box above: