Membership Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Annual Dues: Individual $25 | Household $35 Checks (payable to Portland Metro Prime Timers). Payment may be made at a Saturday Dinner. Please give payment to the Treasurer or Chapter President. Alternatively, you can print an application here. Half price July–December. Dues and donations are not tax deductible. Membership is open to men age 21 and over. Questions? info@portlandprimetimers.org Name *FirstLastPreferred Name on Badge *Phone *Email *Birthday (MM/DD)Like to be a Volunteer? *--- Select Choice ---YesNoDo you have a partner?Partner's NameFirstLastPartner's Preferred Name on BadgePartner's PhonePartner's Email a Partner's Field Partner's Birthday (MM/DD)Partner Like to be a Volunteer? --- Select Choice ---YesNoAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSignature * Clear Signature Submit Online Application