TFOS Membership Payment Instructions & Order Form

  • MAKE SURE COOKIES ARE ON
  • Use only VISA or Mastercard - NO OTHER CARDS ACCEPTED
  • Complete all sections
  • Use only the name on the card for Customer (Bill to); if it is different, use member name for the Ship to section
  • In the State section, if you live outside the US, go to the end of the menu and choose Other/None
  • Don't use dashes, dots, symbols or spaces between the numbers (only the @ in your email address)
  • The CVV2 is the last three numbers on the back of the card above the signature.



    		•
    Title
    First Name
    Last Name
    Institution
    Address
    City
    State
    Country
    Zip code
    Email Address
     
    Membership Type (select one):

    USD$120

    		 "Full Member"

    USD$30

    		 "Student/Fellow" (email ROSE@TEARFILM.ORG with documentation about training status)