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ADDRESS INFO
Membership Type *	JIM MORRIS FAN CLUB LIFETIME Membership ($25.00) Lifetime Membership in JIM MORRIS FAN CLUB (Joining or renewing after 2005)
Payment System *	PayPal Secure Credit Card Payment
Your Name * Your First & Last name
Your E-Mail Address * A confirmation email will be sent to you at this address
Choose a Login Name (User ID) * It must be 5 or more characters in length and may only contain small letters, numbers, and the underscore '_'	check for uniqueness
Choose a Password * Must be 5 or more characters
Confirm your password * Enter password again
Phone number Home phone number
T-Shirt Size t-shirt size for ordering t-shirts	small medium large xtra-large x-xtra large
Birthday Month and Day of Birthday mm/dd
Favorite Song Favoirte Jim Morris Song
Street *
City *
State *
ZIP *
Country *