IAT Membership Registration

Use this form to register to become a member of the Institute for Advanced Theology.

Name Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Phone Phone - ### - ### ####
Membership Levels
- Basic Member $30 per year
  Members are welcome at all Institute events, may participate in meetings concerning the Institute’s development.
- Dual Membership $50 per year
  All the benefits above and two memberships for adults residing at the same address.
- Patron Member $100 per year
  All the benefits above, plus a signed copy of a recent publication of the Institute.
Checkboxes

Checkboxes Basic Membership $30 Dual Membership $50 Patron Membership $100