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Advocate Membership Application





Membership Dues
Your Dues Rate Type is: Advocate Member

Contact Information Contact Information
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Username/Password Username/Password

Please enter the Username/Password you would like to use to login to this website.

  • Your Username must be unique and must be at least 6 characters.
  • Passwords must be a minimum of 8 alpha-numeric characters with at least 1 number or 1 letter.
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Additional Options Additional Options
Select additional contact types to include as part of your membership:

 
Payment Details Payment Details




Enter the name on the bank account according to the information shown on your bank statement. The account number and routing number can be copied from the lower left corner of the check.
By submitting payment, I am authorizing The International Childbirth Education Association to initiate a single or recurring ACH/electronic debit in the amount indicated from the bank account I designated above. I understand that this Authorization will remain in full force and effect until the transaction is cancelled by me by contacting The International Childbirth Education Association, or the ACH/electronic debit is processed from the designated account. I certify that (1) I am authorized to debit the bank account above and (2) the ACH/electronic payment I am authorizing complies with all applicable laws.



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