Your Information
First Name ↓
Last Name
Title ↓
Organization ↓
Phone ↓
Self Identification (Optional) ↓
OPTIONAL: The following questions are optional but help our staff use the most respectful language when addressing you, understanding our membership better, and ensuring a diverse cohort of Fellows.
Payment
Billing Address ↓
Address ↓
Address Two ↓
City ↓
State ↓
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zipcode ↓
Credit Card Information ↓
Card Number ↓
The (typically) 16 digits on the front of your credit card.
CVC ↓
The 3 digit (back) or 4 digit (front) value on your card.
Name on Card ↓
Expiration ↓
Submit
Note: your annual membership will automatically renew at the end of the yearly membership. Before you are billed for the next annual membership, we will notify you regarding the renewal date and membership rate. If you have any questions, please contact us at membership@urbandesignforum.org or 718-663-8478.
