Membership Checkout – Polish Home Association

We accept all major credit cards. To pay by debit or credit card please select PayPal as your payment method.

You have selected the Single membership level.

The price for membership is $40.00 per Year.

Username

Password

Confirm Password

First Name

Last Name

Email Address

Confirm Email Address

Full Name LEAVE THIS BLANK

First Name

Last Name

Address 1

Address 2

City

State

Postal Code

Country

Phone

Card Number

Expiration Date /

Security Code (CVC)

I confirm that I am Polish born or of Polish descent and I commit to uphold and support the purpose and principles of the Polish Home Association.

I agree to the Terms of Service

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