To have the necessary info automatically e-mailed to you, uniquely and accurately identify yourself.
Fill in as many boxes as you need to do so.
Member number alone will suffice, for example.
Just putting 'Bob' in the first name box would be problematic.
    * There may be other Bob's, rendering it not unique.
    * Are you sure you didn't sign-up as Robert, rendering it not accurate?
Fill in only boxes you're sure of,
and if there's any chance another member shares it, fill in a second, or third, etc. before clicking submit.

If you can't have the information e-mailed, contact the administrator: 215-551-1490. h_ours@yahoo.com. 823 Alter St.; Philadelphia, PA 19147.

Member number:  

Name:

First:     
Middle:
Last:     

Phone:  -  -
    extension:

e-mail:

Home address:
Address line 1:
Number and street
Address line 2: Apt. or whatever