Individual Membership Pay Online

Welcome to the page where you can obtain or renew an Individual Membership with the South Dakota Coalition of Citizens with Disabilities.   Please complete the form below.   

Individual Membership is a fee of $20.

First Name: * 
Last Name: * 
Organization:
Billing Name: * 
Billing Address: * 
Billing City: * 
Billing State: * 
Billing Zip Code: *  
Billing Phone: *  
Cell Phone: 
E-Mail Address: *  
Are you a member of the COALITION?: *
 
I would like to receive the COALITION Newsletter "Focus on Abilities" in the following format: *
 
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