Enrollment Application

Please See Member Fee Payment Options Below:

Pay with Credit Card

  Individual Family Plan
Monthly Only $6.00 $10.00

There is a one time application fee of $20.00.

Credit Card Application

Pay with Bank Draft

  Individual Family Plan
Monthly Only $6.00 $10.00

There is a one time application fee of $20.00.

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Pay with Check or Money Order

  Individual Family Plan
Annual Only $72.00 $120.00

There is a one time application fee of $20.00.

Printable Application

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