QPS Gift Membership Application Form

Please print and complete the printable form below ONLY if you will be mailing a check or money order. Scroll down the page for PayPal options if paying with credit card.

  






GIFT MEMBERSHIP IS FROM:


First name: Last name:

Address:

City: State: Zip:

Email::

Phone:

Are you currently a QPS member?

YES NO

GIFT RECIPIENT INFORMATION

First name: Last name:

Address:

City: State:

Zip:

Email::

Phone:

Membership dues are in US currency for One (1) Year

US $15us

Canada $17us

Student $15us

Other International $27us

Please complete form, and mail your check or money order to:

QPS
P.O. Box 7241
Eugene, OR 97401

Or, to purchase membership using paypal:

Or, to purchase student membership using paypal:

To purchase Canadian membership using paypal:

To purchase international membership using paypal: