Thank you for joining and showing your support for Reflexology! We will email you.

First Name * Last Name * Email * Mailing Address * City, State and Zip * Mobile Phone Date of Birth (full date or day & month only) Name of Reflexology School

Type of Membership *

Student of Reflexology Retired Reflexologist

Choose dues: *

Retired or Student New Member or Renewal, per year ($45 USD) Retired or Student New Member or Renewal, 2 years ($80 USD)

How did you hear about RAC?

Colleague/Friend Fair/Event Website Newsletter Flyer/Brochure Social Media

Name of person who referred you:

Please verify: *

I meet the requirements for Student or retired reflexologist If any of the above is found incorrect, my membership can be denied

Signature * Date *

* indicates required fields