User account

After completing this form, please remit a check for the correct amount (see below), to Maxine Daly, the W.E.B. Treasurer, so your account can be activated. Checks can be mailed to the address below or hand-delivered at the next W.E.B. meeting.

P. O. Box 1801, North Mankato, MN 56003

Dues: $80 in June to Oct., $70 in Nov, $60 in Dec, $50 in Jan, $40 in Feb, $30 in Mar, $20 in Apr and $10 in May (the last meeting of the year).

Questions? (507) 340 - 7678

Username: *

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E-mail address: *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

Password: *

Confirm password: *

Provide a password for the new account in both fields.

Member Information

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Business Information

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Description of your business or profession:

Business Address: *

Business City: *

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Zip Code: *

(5 or 9 digit US zip)

Work Phone: *

Fax:

Business Name: *