Lifelong Learning Centre Membership

Telephone: 239-4029
Email: llc@college.bm

Please choose your membership type: *

Lifetime Membership - $ 500.00

Annual Membership Plus - $ 50.00

Annual Membership - $ 30.00

BermudaTix fee *

Convenience fee - $ 2.00

Optional donation

Total Amount

Name and Address (LLC)

First Name *

Last Name *

Mailing address

City (Leave blank for Bermuda addresses)

Postal Code

Country

State/Province/Parish

Phone- (Home)

Phone-(Mobile)

Phone-(Work)

Email *

Birth Date (MM/DD/YYYY) *

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City (do not use in Bermuda)

Country *

Parish/State/Province *

Postal Code *

Add'l info LLC

List your areas of interest

Are you willing to teach in an area?

Yes

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