World Polyamory Association

World Polyamory Association
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POLY-FRIENDLY PROFESSIONALS

Certified Professional Membership Form | Poly-Friendly Professionals Form | Professional Memberships |
Membership Registration Form | Presenter's Application Form

You must be a MEMBER of the World Polyamory Association to be listed on the web site. Free Members receive a basic listing which is your name, email, web site, state and phone. Paying Members receive a full listing with a longer description of the work you offer to the public. After you complete the MEMBERSHIP FORM, return to this form and fill it out to be listed in our Poly-Friendly Professionals Directory. Mahalo.

Please provide the following contact information:

First Name

Last Name

Middle Initial

Title

Organization

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

Home Phone

FAX

E-mail

URL

Please provide your account information:

User Name

Password

Confirm Password

Post Nominals (credits after name)

Associations and recognitions (use separate email if necessary)

Please give us a statement promoting your business to appear in the Directory of Professionals.

How does your business serve the poly community?

CANCELLATION POLICY

No Refunds on Membership Fees

Refund Policy for Conferences & Events:
90 days or more - Refund fee is 25% of price
60 days or more - Refund fee is 50% of price
31-59 days - Refund fee is 75% of price
30 days or less - Refund fee is 100% of price
5 days or less - no credits or refunds

To Cancel send your request in writing to:
WorldPolyamory@aol.com or write to

World Polyamory Association
1371 Malaihi Road
Wailuku, Hawaii 96793
Be sure to include your name, address, email and phone.

After you register, and if you cannot attend the Conference or Event, you may:
1. Send a substitute or
2. Receive a credit memo to be applied in one year (12 months) toward another WPA event.

Returned checks will be charged a $25 bank service fee.

Copyright © 2004 [WorldPolyamoryAssociation]. All rights reserved.
Revised: November 08, 2009