Welcome to Member Connect! This is where members connect with each other via email. Communication is easy and all email addresses are masked. It's easy, safe and a great way to meet others living in Seattle.
FAX
Please use the form to sign up for Member Connect. You will be providing your credit card information. Your credit card will then be debited once a month under the plan that you select. Print this form and fax it to (206) 338-2318.

Select Plan: (check the plan)
    6 months $5.95 per month
    3 months $6.95 per month
    1 month $8.95 per month

Credit Card:
CREDIT CARD
  Card Type    
  Card Number  
  Expiration Date Month/Year
  Name as it appears
on card
  Card Security Code
     

BILLING ADDRESS
  First Name
  Last Name  
  Billing Addr  
  Billing Addr
  City
  State
  Zip Code  
     
     
I agree to the Member Connect terms of use


Please indicate the best phone number and email to reach you in case we have questions:

Phone Number: ____________________________________
Email: ____________________________________



Finally, sign the form below and then fax to (206) 338-2318 . Your subscription will be processed within 48 hours or less.

By signing this document, I assert that I have read and agree to the Member Connect Terms of Use.

Printed Name: ____________________________________
Signature: ____________________________________




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