Supporting Membership

Terms:

$125 / Year

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Job Title: Job Title is not valid

Library or Organization: Library or Organization is not valid

Specific Branch or Department Name: Specific Branch or Department Name is not valid

BC Region: BC Region is not valid

Contact Name: Contact Name is not valid

Contact Job Title: Contact Job Title is not valid

Contact Department: Contact Department is not valid

Contact Email: Contact Email is not valid

Alternate Contact Name: Alternate Contact Name is not valid

Alternate Contact Job Title: Alternate Contact Job Title is not valid

Alternate Contact Department: Alternate Contact Department is not valid

Alternate Contact Email: Alternate Contact Email is not valid

Sections, Committees, and Interest Groups (BCLA Members Only): Sections, Committees, and Interest Groups (BCLA Members Only) is not valid

Participate in Perkopolis discount program (BCLA Members Only):* Participate in Perkopolis discount program (BCLA Members Only) is Required

Yes No

I meet the requirements for a Supporting Membership as outlined above.*

I have read and agree to the BCLA Online Community Guidelines, Privacy Policy, and Website Terms of Use.*

I agree to receive communications from BCLA. (Consent can be withdrawn at any time.)*

Username:* Invalid Username

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

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Coupon Code:

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