Eater Membership and Sign-Up Form

Thanks so much for your support!

Please 1) read all the instructions, 2) fill out the form below, 3) print a copy for your records, and then 4) click SUBMIT (or come back here) to make a secure payment with PayPal.

For any general membership questions or concerns, please contact our Membership Coordinator: Brandi (a) kcfoodcircle . org

Please note: If you are not automatically redirected to Paypal after completing your membership form, click here to make your payment online. Your sign-up is not complete until you make a payment.

ALTERNATE MAIL-IN: Not comfortable paying electronically? No problem! Download the KCFC Eater Membership Form (.pdf) and mail your printed form to us with a check made out to *HAAL or Heart of America Action Linkage. Please include KCFC Eater Dues in the memo.

Our mailing address:
KC Food Circle
P.O. Box 20181
Kansas City, MO 64195
* The Heart of America Action Linkage (HAAL) is our non-profit 501(c)(3) parent organization.

NOTE: Your contact and payment information will only be used for Kansas City Food Circle membership processing, and it will never be shared with any third party for any reason.

If you experience any trouble filling out or submitting this form, please call Dave Lawrence at 913-620-8427 for support.

* indicates required field

NAME USED on PayPal/Credit Card (or enter "Paying by Check")*

Email:*

Re-enter Email:*

Your Full Name (for our Contact List)*

Personal Note:

Please enter TYPE OF MEMBERSHIP

\"EATER $30\" or \"Student/Senior $15\"*

Primary Phone / Secondary Phone*

We need your mailing address in order to send your
Eat Local & Organic Diner's Card (at the very least).

STREET*

CITY*

STATE*

ZIP CODE*

Leave this field unchanged if you wish to HELP US SAVE valuable resources and minimize postal mail expenses - otherwise, replace it with the word "NO" and we'll send future newsletters and other essential or seasonal communications by postal mail.

MAKE MY MEMBERSHIP ELECTRONIC

YES! I want to VOLUNTEER with KCFC: (check all that apply)

Tabling & Outreach
Annual Expo
Fundraising
Membership
Tech/Web Development
Other

Send email to [email protected] for more info.

Enter the characters shown in the graphic above. If you cannot read the code, click the little refresh button at the top-right of the graphic image.*

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