Membership Application

Thank you for applying for a membership with Titans of the Midwest.  In filling out the application below, we ask for your legal first and last name.  This legal name is kept "behind the scenes" and will not be published.  You are welcome to also add a nickname that we will use when referring to you publicly.  Membership dues will be collected after your membership is approved.  

Membership Application
Total Amount
Please enter a Username to create an account. If you already have an account please login before completing this form.
Membership information
Provide a nickname you don't mind being public.
What region do you live in? North: MN, WI, MI, Chicago Metro East: IL (other than Chicago), IN, OH, KY West: NE, IA South: KS, MO, OK
Please describe your interest in the Titans of the Midwest and why you want to be a member.
Please tell us about yourself. The Executive Committee typically does not approve applications if we don't know you or you don't provide information about your interest in our organization. Please include other groups you are a member of.
Upon approval, you are granted a Titans of the Midwest pin. We can either mail this to you (no shipping charge), or give it to you in person at an event or function. Please indicate your preferred delivery method.
If the $30 annual dues is a significant financial burden for you, please describe your situation and how you will volunteer for the Titans of the Midwest in the coming year to compensate for the dues.
If you stated that dues are a financial burden above, please describe your situation and how you will contribute to the Titans of the Midwest over the coming year.
Payment Options
[x] Pay Later