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WAO WAO Printable Membership Form
If you are paying by credit card, be sure to provide all the required card and cardholder information. Then:
  • fax completed form to
    212.674.3057
    - or -
  • mail completed form to
    WAO National Office
    250 Park Avenue South
    New York, NY 10003
 If you are paying by check, please be sure your check is signed and dated. Then mail completed form (with check) to:
  • WAO National Office
    250 Park Avenue South
    New York, NY 10003

Membership Options (check one):
   ___ Standard - $36
   ___ Lifetime Member - $500

        ___ One-time payment - $500

        ___ First of two payments - $250
   ___ Special Member - $75

   ___ Contributor - $136

   ___ Silver - $286

   ___ Global - $536

   ___ Golden Circle - $1,000

   ___ Major Gift - $5,000

   ___ Pacesetter - $25,000
    Additional Contribution: ____________ (Thanks for your extra support!)
    Are you an existing WAO member? ___ Yes    ___ No

Member Info:
Name: ____________________________________
Street Address: ________________________________________________
City: ____________________________________
State: ____________________________________
ZIP: __________
Country: ____________________________________
Phone: ___________________
Email Address: ____________________________________
___ You may send me periodic updates via email.

Credit Card Info:
Credit Card Type: __ Visa      __ Mastercard      __ American Express
Name on Card: ____________________________________
Card Number: ____________________________________
Expiration Date: Month (MM) ____  Year (YY) ____

Cardholder Info (only if different from Member Info):
Billing Address: ________________________________________________
City: ____________________________________
State: ____________________________________
ZIP: __________
Country: ____________________________________
Phone: ____________________

Gift Membership (optional):
Name: ____________________________________
WAO can send a card in recognition of your gift membership. If you would like us to do so, please complete the following information.
1. Who would you like the card sent to?
Name: ____________________________________
Address: ________________________________________________
City: ____________________________________
State: ____________________________________
ZIP: __________
Country: ____________________________________
2. Personalize your card:
To: __________________________    From: __________________________
3. Personalized inscription (optional) - up to 25 words: