Online Application and Payment – Prime Timers of Phoenix

New: Complete Your Membership Application Online

Your PTOP application can now be filled out and submitted online. Required fields are designated by a red *. If you have filled out the form correctly you will see the following message: “Thanks for submitting your online PTOP application.” after hitting the submit button.

Why not also pay your dues online? At the bottom of this page, you will find buttons that will allow you to pay your dues online through Square. If you decide to pay online, please know that a $1.50 convenience charge will be added automatically.

Prime Timers of Phoenix - Membership Application

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First Name *

Last Name *

Birthdate (mm/dd): *

Street Address or P.O. Box #:

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City:

State:

Zip Code:

Phone number and/or email address is required. Please check the appropriate box so those fields will appear. Please check one box. *

Email Address
Phone Number
Both

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How did you hear about Prime Timers of Phoenix?

Is this Membership Application also for your partner? *

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Name tags are available for purchase. Select (pin or magnet) based on the type you want and add $15 to your payment. Please be sure to also click the name tag button below if you want a name tag.

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Name tag selection

Pin
Magnet

How do you want your name tag to read?

Dues include an e-mail edition of the monthly PTOP Newsletter and quarterly PTOP Roster. If you wish to have a paper copy of the monthly newsletter and/or quarterly roster mailed to you, please contact the Membership Director for the cost. PTOP Membership Director is Mike G., at boothgetz@gmail.com

Payment: If you prefer paying with cash or check, please print and sign the application and either bring it to a meeting, or mail it to PTOP at 401 E Paradise Lane, Phoenix, AZ 85022. Please do not send cash through the mail.

Website: Don’t forget to visit our website which will have our monthly calendars, newsletters, and other
information: phoenixprimetimers.com

The PTOP Membership Directory is confidential and intended to assist members in networking with other PTOP members. Directory information may NOT be used to contact PTOP members to advertise or sell products or services of any kind. Nor may the PTOP Directory be shared with any non PTOP individual for any reason. Doing so will result in the individual(s) immediate termination of his PTOP membership.

Release of Liability to Prime Timers of Phoenix (PTOP)

The signature(s) below indicate: (1) That I am at least 21 years of age; (2) I will not now or at any time hold the directors, members, or any other entity associated with PTOP liable for any type of injury, physical or otherwise that may occur as a result of my participation in any PTOP activity; (3) I release PTOP of all liability in publishing contact information in the confidential directory distributed only to PTOP members and any picture published by Prime Timers Worldwide and PTOP; and (4) I will abide by the current by-laws of PTOP.

Note: By typing name below, it will be considered your legal signature.

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Signature *

Date: *

New: Pay Your Annual Membership Online

Dues can now be paid online through Square. Click on the following button and select the appropriate amount. Dues are prorated for new members from July 1st – September 30th at $15. After October 1st, dues for new members are $25 and includes membership for the following year (three months at no charge). If you decide to pay online, please know that a $1.50 convenience charge will be added automatically.

Click on the button to pay for your PTOP membership name tag.