Please fill out the form below and mail it along with your check or money order for $20.00 made out to: Kathy Smith

Mail to:
Kathy Smith
16301 Ten Mile Road
Eastpointe, MI  48021

If you prefer, you may purchase your membership via Paypal. Please complete the form below and submit it via e-mail. Then return here and click on the button below to submit payment! When you pay via Paypal, you will receive an e-mail from Elf Sandy within 24-48 hours containing your member password and other information!

P.A.S.E., Inc. Membership Age Requirement
Individuals must be 18 years or older to complete the Membership Application. If an individual under 18 wishes to join P.A.S.E., Inc., he/she must do so with the permission and participation of a parent or guardian. P.A.S.E., Inc. requires that the parent or guardian e-mail Board Member, Kathy Smith, at SimplyKath@sbcglobal.net regarding approval of the application.
P.A.S.E., Inc. is committed to upholding the Children's Online Privacy Protection Act (COPPA) of 1998 as well as the privacy of all our members. (See also P.A.S.E., Inc. Privacy Statement.)

First Name:
Last Name:
Address:
(street, city, state, zip)
E-mail:
How did you hear about P.A.S.E.?
Comments or questions:

(be sure to print a copy before submitting)

Thank you!