Membership:
MEMBERSHIP FEES NO ACTIVATION FEE!! ACCESS TO ONLINE PLANS IS INCLUDED

AMOUNT       (       ) $395 for 6 months
AMOUNT       (       ) $595 for 12 months
AMOUNT       (       ) $1050 for 24 months

$____________________  TYPE OF CARD _____________

 CREDIT CARD # ________________________________

 3 NUMBERS ON BACK OF CARD ________  (or 4 Numbers on front of AMEX)

EXPIRATION DATE: _____________________

FULL NAME AS LISTED ON CARD: 

FIRST ____________________________

LAST ____________________________

 ADDRESS CREDIT CARD BILL IS MAILED TO: 

________________________________________

________________________________
City, State, Zip

PHONE NUMBER ASSOCIATED WITH THIS CARD (_____)__________________________________

 YOUR EMAIL ADDRESS:  ________________________________________________

 I hereby authorize Sierra Plan Room to charge my credit card in the sum listed above.

 Signature: _____________________________________

 Print name _________________________________________

*IF YOU HAVE A PAYPAL ACCOUNT, YOU CAN SEND THE PAYMENT TO sierraplanroom@yahoo.com 

(Fill this out and either fax to 702/871-8220, email to sierraplanroom@yahoo.com or mail to Sierra Plan Room; 9348 Villa Tuscany Ave; Las Vegas, NV 89129)

Fill out the membership application as well and get it back to us.

MEMBERSHIP
APPLICATION