Name
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{ binding firstError.message }
Is this application for a
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
a new member
a new member
renewing existing membership
renewing existing membership
{ binding firstError.message }
Email
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{ binding firstError.message }
Representing
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{ binding firstError.message }
{# page1_NextButtonText}
Save
Job Title
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{ binding firstError.message }
Address
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{ binding firstError.message }
City
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{ binding firstError.message }
State
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{ binding firstError.message }
Zip Code
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{ binding firstError.message }
Phone
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{ binding firstError.message }
Fax
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{ binding firstError.message }
Back
{# page2_NextButtonText}
Save
If paying by check, please make payable to:
NCGFOA
Mail “application” and check to:
NCGFOA
c/o NC League of Municipalities
150 Fayetteville St, Suite 300
Raleigh, NC 27601
Invoice #
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{ binding firstError.message }
Customer #
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{ binding firstError.message }
Payment Method
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
Online
Online
Mail In Check
Mail In Check
{ binding firstError.message }
Registration is not complete until payment has been submitted & processed.
Membership Types
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
Member $50
Member $50
Associate Member $100
Associate Member $100
{ binding firstError.message }
If paying online, please use the following section to submit payment. Otherwise, leave this blank.
Dues/Membership Type
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
Member - $50.00
Member - $50.00
Associate Member - $100.00
Associate Member - $100.00
{ binding firstError.message }
{~ Payment_Block_Label}
{binding Group}
{binding Name}
-
{binding Description}
{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}
{binding displayValue}
{binding Name}
:
{binding displayValue}
---
{{ Cognito.resources['payment-amount-due'] + ":" }}
{binding displayValue}
Back
Submit
Processing PayPal Payment
Save
{{ Cognito.resources['order-transaction-details-header'] }}
{{ Cognito.resources['order-number-label'] }}:
{binding displayValue}
{{ Cognito.resources['order-date-label'] }}:
{binding displayValue}
{{ Cognito.resources['order-method-label'] }}:
{binding MethodReference}
{binding Group}
{binding Name}
-
{binding Description}
{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}
{binding displayValue}
{{ Cognito.resources['order-total-label'] }}:
{binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:
(
{binding displayValue}
)
{{ Cognito.resources['order-balance-due-label'] }}:
{binding displayValue}
Name
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Is this application for a
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Representing
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Job Title
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Address
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
City
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
State
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Zip Code
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Fax
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
If paying by check, please make payable to:
NCGFOA
Mail “application” and check to:
NCGFOA
c/o NC League of Municipalities
150 Fayetteville St, Suite 300
Raleigh, NC 27601
Invoice #
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Customer #
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Payment Method
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Membership Types
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
If paying online, please use the following section to submit payment. Otherwise, leave this blank.
Dues/Membership Type
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
The email has been sent.
Your progress has been saved.
Copy your form link:
Email me my link:
Send
{ binding firstError.message }
{{ Cognito.resources['order-transaction-details-header'] }}
{{ Cognito.resources['order-number-label'] }}:
{binding displayValue}
{{ Cognito.resources['order-date-label'] }}:
{binding displayValue}
{{ Cognito.resources['order-method-label'] }}:
{binding MethodReference}
{binding Group}
{binding Name}
-
{binding Description}
{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}
{binding displayValue}
{{ Cognito.resources['order-total-label'] }}:
{binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:
(
{binding displayValue}
)
{{ Cognito.resources['order-balance-due-label'] }}:
{binding displayValue}
Name
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Is this application for a
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Representing
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Job Title
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Address
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
City
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
State
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Zip Code
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Fax
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
If paying by check, please make payable to:
NCGFOA
Mail “application” and check to:
NCGFOA
c/o NC League of Municipalities
150 Fayetteville St, Suite 300
Raleigh, NC 27601
Invoice #
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Customer #
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Payment Method
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Membership Types
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }
If paying online, please use the following section to submit payment. Otherwise, leave this blank.
Dues/Membership Type
{{ Cognito.resources["required-asterisk"] }}
,
{ binding firstError.message }
{binding displayValue}
{ binding firstError.message }