The List Membership Activation!

First Name, Last Name *

Please enter your first and last name.

Address (ex. 8818 W. Sunset Blvd.) *

Please enter your street name.

City, State and Zipcode *

Please enter your city, state and zipcode.

Phone Number *

Please enter your phone number including area code.

Email Address (johndoe@example.com) *

Please enter your email address.

Activation number (found on the back of the gift of membership card) *

Please enter the full activation number that can be found on the back of your gift of membership card.