WWW.DAKOTA-DURANGO.COM SITE SUPPORTER MEMBERSHIP FORM
SECOND YEAR RENEWAL SUBSCRIBERS ONLY

THIS MEMBERSHIP PACKET IS ONLY AVAILABLE TO FORUM USERS WHO ARE RENEWING FOR A SECOND YEAR

IF YOU ARE A FIRST TIME SUBSCRIBER SUBSCRIPTION,
PLEASE CLICK HERE TO FILL OUT THE MEMBERSHIP FORM

The information submitted on this form is only used to process your membership packet.
Personal information is never shared with any outside organizations.

Second Year Site Supporters receive a membership packet containing the following items:

1x GLASS MUG

www.Dakota-Durango.com mugs are made of high-quality glass, and hold 19.5 oz. of your favorite beverage.

FRONT: BACK:

1x SHOT GLASS

www.Dakota-Durango.com shot glasses are made of high-quality glass, and hold 2 oz. of your favorite beverage.

FRONT: BACK:

25x WEBSITE CARDS

Business Card Size
2-Sided, Full Color

FRONT:

BACK:

If you are interested in purchasing additional website merchandise, please click here.

REQUIRED INFORMATION
Your First/Last Name:
Your eMail Address:
Existing Forum User Name:
Shipping Address:
City:
State:
Zip:
Phone Number:
MEMBERSHIP PACKET CONTENTS
Glass Mug:
Shot Glass:
ADDITIONAL INFORMATION
Method of Payment:
Comments: