Membership Application

Join the SMART TD Auxiliary today!

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Birthday *

Phone Number *

Alt. Phone Number *

Receive Text *

Yes No

Receive Text (Alt. Phone Number) *

Yes No

Email *

Receive newsletter via email *

Yes No

Auxiliary Constitution via email *

Yes No

Referred by: *

How did you hear about us? *

Submit

Membership Application Fee is $10

You will receive an email within 72hrs of submitting application letting you know which lodge you have been placed in.
Annual lodge dues run between $60-$80 and are paid to the lodge.