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Membership Application

Full Name:

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Organization / Company:

Billing Address:

City:

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Zip:

Home Phone:

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Contact Email:

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Membership Level You Are Applying For:

Supporting RTPnet (no Hosting) $25 Min.
Starter Internet - $60
Mid Internet - $75
The Works - $100
We need:
Web Space
Email

Domain Name:

(if you don't already have a domain name, click here

Contact Person (in addition to the one above)
Name:
Email:


Any Special Requirements or Comments:

Payment Options:

Check here if you wish to pay by check.

    Please mail a check for the correct amount to:
      RTPnet
      5421 Wayne st.
      Raleigh NC 27606

Check here if you wish to pay through PayPal.

    Make a PayPal payment to pppayments@rtpnet.org.


Clicking "Submit" below indicates that:

  • You have read our Policy Document
  • You have been appointed to represent the organization seeking membership.
  • The organization's information will be kept up to date.
  • The organization will provide timely response to email.