New Membership by Check

New/Renew Membership
by Check

Please provide us with the following information below:

[contact-form to=’subscriptions@6beds.org,it@6beds.org’ subject=’New membership subscription (Credit Card).’][contact-field label=’Licensee(s) Name’ type=’name’ required=’1’/][contact-field label=’Mobile | Contact Phone No.’ type=’text’ required=’1’/][contact-field label=’Fax No.’ type=’text’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Website’ type=’url’/][contact-field label=’Mailing Address’ type=’text’ required=’1’/][contact-field label=’Total RCFE Facilities You Operate’ type=’text’/][contact-field label=’Total ARF Facilities You Operate’ type=’text’/][contact-field label=’Facility Info: Name | Address | County’ type=’textarea’ required=’1’/][contact-field label=’Membership Subscription’ type=’radio’ required=’1′ options=’Annual – $600,Semi-Annual – $300,Quarterly – $150,Monthly – $50’/][contact-field label=’Comments’ type=’textarea’/][/contact-form]

SEND CHECK TO

6Beds, Inc.
PO BOX 5423
South San Francisco, CA 94083

6BEDS is a Mutual Benefit NON-PROFIT Corporation. Part of the membership fee is tax-deductible (consult with your tax advisor). Membership fees are non-refundable. Thank you for supporting our industry.