Online Application

Please note: Only new members or renewing members whose information has changed need to fill out an application.

1. 1. Complete your application online by filling out the fields below and then click on the submit button. Fields with a red * are required.
  2. Pay your dues online, in person, or by mail.
  3. Please note: Even if you complete your application and pay online, we must meet you in person before you can be confirmed as a member. As stated in the application, you further understand that your membership requires final confirmation by the PTDFW Officers.

Name *

First

Last

Street Address *

City *

State *

Zip Code *

Phone *

Can you receive PTDFW text messages? *

Birthday (MM/DD) *

Email *

Is it okay to send you emails? *

Do you want to be listed in the PTDFW roster? *

Does PTDFW have permission to use your photo when taken at group events? *

How did you learn about Prime Timers?

Pay $35 online using Zelle (preferred) or $37 online using Square. OR
Pay in-person at a selected PTDFW event. OR
Mail a check (please do not send cash) payable to: PrimeTimers Dallas-Fort Worth, P.O. Box 191101, Dallas, TX 75219-8101

Please check the box to indicate that I agree to the following when I sign and submit this application. *

I wish to join PTDFW, and I am at least 21 years of age. As a member, I agree to keep the membership roster PRIVATE and CONFIDENTIAL. I further understand that my membership application is pending final confirmation by the Chapter officers, whether as a renewal or first-time applicant.

Signature *

Signature Date (MM/DD/YYYY) *