NEW MEMBER APPLICATION



We welcome anyone as a member who supports the goals of EX-POSE.

Contributions to EX-POSE are TAX-DEDUCTIBLE.

Membership dues are NOT TAX-DEDUCTIBLE.



Click on each appropriate box to enter your data:

NAME: Last First MI

ADDRESS to which your membership packet should be sent:

      1st Address Line Apt.

      2nd Address Line (if needed)

      City     State     Zip +

      Country

PHONE:   Home   Work  Cell

E-MAIL:


INDIVIDUAL MEMBERSHIP:

$35 Annual Membership + $10 postage for New Member Packet                             $


ATTORNEY MEMBERSHIP:

$85 Annual Membership + $10 postage for New Member Packet                             $


CONTRIBUTIONS:

Contributions to EX-POSE are TAX-DEDUCTIBLE.                                                 $

Membership dues are NOT TAX-DEDUCTIBLE.


ADDITIONAL ARTICLES FOR SALE:

Guidelines for selecting a divorce attorney, authored by Ed Schilling, Esq.
      $6.00 for new members (* $6.50 only for Virginia residents, includes sales tax) $

30 Days to Prepare for Separation and Divorce
      $6.00 for new members (* $6.50 only for Virginia residents, includes sales tax) $

Additional Copies of the New Member Newsletter
      $10.00 each + $3 postage                                                                                             $



Check number or Money Order number

TOTAL AMOUNT                                 $
(for Membership Dues, Contributions, and/or Articles)



MILITARY AFFILIATION OF SERVICE MEMBER:

      Place x in appropriate box:

      Army     Air Force     Navy     Marine Corps
      Coast Guard     National Guard     Reserves     Other




Location of divorce proceedings, for list of possible attorney members in that state:

     



To clear and re-enter typed data, please hit

Now print page and MAIL CHECK OR MONEY ORDER (payable to EX-POSE) for Membership, Contributions, and Article to:


EX-POSE
P.O. BOX 11191
Alexandria, VA 22312-0191









For new member applicants:

Please fill out privacy card and include with above form.

EX-POSE has a strict policy of never volunteering information about members to outside parties or vendors, barring explicit permission from the member in question.

Signing this Privacy Card offers a further level of insurance against EX-POSE having to disclose information about members to anyone who might actively seek or request it.


Privacy Card


EX-POSE
P.O. BOX 11191
ALEXANDRIA, VA 22312-0191

    If you do NOT want to have
your name and address released from
our files, please sign below and return
this card to the address above.


  I do not want to have my name and
address released to ANYONE.

_______________________________
Signature

_______________________________
Print Name & State