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*Area Code : *Telephone Number : Fax :

 
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* How or from whom did you hear about ClearStar?

 

*Amount of Payment - Choose correct category below. All funds USD 
for Regular ClearStar Members
who are not members of ALOA, SAVTA, or ILA

1 Year is   $   75
2 Years is $ 145   $  5.00 savings
3 Years is $ 215   $ 10.00 savings
Life Membership is $ 395 includes Life Member Designation LCSM ----
                                            The pro-rated amount of your current
                                            membership will also be subtracted from this.

for ALOA or ILA Members ONLY :

1 Year is  $   60
2 Years... $ 115   $  5.00 savings
3 Years... $ 170   $ 10.00 savings
Life Membership is $ 385 includes Life Member Designation LCSM ----
                                            The pro-rated amount of your current
                                            membership will also be subtracted from this.
for SAVTA Members ONLY :

1 Year...   $   60
2 Years... $ 115   $  5.00 savings
3 Years... $ 170   $ 10.00 savings
Life Membership is  $ 370 includes Life Member Designation LCSM ----
                                            The pro-rated amount of your current
                                            membership will also be subtracted from this.

*I am paying my dues by - Select A Payment Method:
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2 for Year

example: 1014

 *Card ID Number (CVV2, CID)--------------->

3 digits on back of VISA and Mastercard

( 4 digits on front of American Express card)

examples: 678  or  1234


If you are a member of ALOA, SAVTA or ILA - Fill in the boxes below
 
I hereby swear that I am a current
paid-up member of
at least one of the following...
ALOA, SAVTA or ILA

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 For members of

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print this completed form and include it with your payment, and...



Fax Number: 1-866-850-9926 (toll free)

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ClearStar Security Network
Internet Administration
4454 Lopez Ave
Port Townsend, WA 98368



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