* 1. I hereby state that I am requesting a 1-year TCME membership fee reduction, due to financial hardship. Please provide a short description of the reasons why you wish to become/continue to be a member of TCME for the following year.

* 2. Please provide your name, credentials (if applicable) and email address where we can reach you.

* 3. Please provide a short description of the reasons that make the annual TCME membership rate unaffordable to you.

* 4. Please set a donation fee that is affordable to you for a one-year membership to TCME, in USD.

* 5. Please check all that apply:

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