HDP Membership Application

personal info
first & last name
address
city
state/province
zip/postal code
country
home phone
cell phone
e-mail
tell us a little about yourself and your study of Human Design
birth day
birth month
birth year
birth time
birth place
membership level
student	$40 one year
practitioner	$60 one year
practitioner	$150 three years
practitioner	$800 lifetime
sponsor	$ in addition to above
if you apply for professional level
	I would like to be listed in the guest area on humandesignsystem.net
anything else?
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