Ways to Join:

Use our Online Membership application below.
Pay your dues online; we also have a Under Construction Downloadable Application Form.
Print it, fill it out, and bring the completed for to an upcoming meeting with payment.

Online Membership Application Instructions and Tips:

1. 1. Fields with an * are required.
  2. After tapping the Submit button, check the top of the form to be sure it went through or needs additional information.
  3. After this form is submitted, scroll down to the “Online Dues Payment” section, if you want to pay online. Be sure to select the payment amount that is correct for your time period.
  4. Payment should be received within 7 days after submitting the online application.
  5. If there are any questions about completion of this form, use this Contact Us link to send us an Email.
  6. The application form has a box to submit a current picture. Send a selfie if you wish.

Date of Application *

First *

Last *

Middle *

Street Address *

City *

State *

Zip *

Date of Birth *

Email *

Phone *

Phone Type *

Cell
Land Line

Is it OK to call you at this phone number? *

Membership Dues based on Date Joined/Paid. Select only one. *

Dues for a new member decline semiannually and all members can rollover the following January at the lower 'Rollover' amount. Dues are subject to change for next calendar years.

Dues information

Please follow our links to pay online with Square. Please describe how you would like to pay. Examples: online, at meeting, mail check.

Have you ever been convicted of a felony? *

Signature

Clear Signature

By signing and submitting this application for membership, you certify that you are a least 21 years old, self-identify and present yourself as a gay or bisexual man, subscribe to PrimeTimers® of Charlotte's purpose of socialization and fellowship in a safe and respectful environment, and agree to comply with Chapter operations, policies and procedures. Signature of Applicant. By placing NAME and DATE in this box you indicate your agreement and that serves as your signature. *

File Upload

Drag & Drop Files, Choose Files to Upload

--Pictorial Directory. 99% of our members choose to have their pictures in the chapter Pictorial Directory because it is an excellent tool for members to get to know one another. All members receive updated directories in PDF format, but they will not be distributed beyond the membership. Please copy and paste your picture here if you would like to be included in the directory (rather than a generic silhouette).

How did you find out about us?

Please tell us how you found us. Example: 1.) From a current member - what is their name? 2.) Surfing the internet. 3.) An article found in newsletters/magazine.