[PLEASE NOTE: if you are a NEW member, first go to the "Login" section (in the left-hand column), click on "Create a New Account" and fill out the information. This gets you registered in our system (and makes sure you are a real human being). Once you are registered...]

Payment by check: Please provide the registration information below. Mail registration information and check to:

Confirmation of your registration will be sent to you once your information has been received and your check has been processed.

Name of Member:

__________________________________

(If registering as a couple, name of partner):

__________________________________

Address/ City/ State/ Zip:

___________________________________


___________________________________

Telephone numbers:

1. _______________________________


2. _______________________________

E-mail addresses:

1. _______________________________


2. _______________________________

Membership levels:

Basic/ Student/ Third World: $36 ($3 per month)

Mender: $120 ($10 per month)

Sustainer: $1,200 ($100 per month)

Seva (Service): $3,600 ($300 per month)

Amount of check: $________________


(Make check payable to “Commonway Institute”)