Membership Dues Transmittal — Long Form — MCL Department of Arizona

Department of Arizona

Membership Dues Transmittal — Long Form

Complete all sections below. Add each member, select their code, and fill in dues quantities. Click Submit & Send to generate the official PDF and deliver it to the Department Paymaster.

⚠️

Long Form — 7 or More Members Only

This form is for transmittals listing 7 or more members. If you are submitting 6 or fewer members, please use the Transmittal Short Form instead.

🎖️ Detachment Information

Detachment Name & Number *

— Select your detachment — ▾

Department

Division

Transmittal Date *

Transmittal #

💰 Detachment Paymaster

Paymaster Name *

Email *

Address Line 1

Address Line 2

City

State

Zip

Phone

🏛️ Department Paymaster

Dept. Paymaster Name

Dept. Paymaster Email

Dept. Paymaster Phone

💵 Payment

Payment information is required to submit this form. Select your payment method below.

Department Dues Amount *

Payment Method *

📊 National Dues Breakdown

Enter the quantity for each code used in this transmittal. Totals are calculated automatically.

Code & Description	Cost/Member	Qty	Total
NATIONAL DUES TOTAL			$0.00

👥 Members

💡 Press Space in any field to leave it blank on the PDF. Maximum 51 members per transmittal.

Sent automatically from webmaster@mclaz.org to the Department Paymaster. You will receive a confirmation copy.

📖 Transaction Codes

N — New Member (Jul 1–Feb 28) $25
NAM — New Associate (Jul 1–Feb 28) $25
NDM — New Dual Member (Jul 1–Feb 28) $25
R — Renewal $20
RAM — Renewal Associate $20
RDM — Renewal Dual $20
R/I — Reinstatement $20
N* — New (Mar 1–Jun 30) $15
NAM* — New Assoc (Mar 1–Jun 30) $15
NDM* — New Dual (Mar 1–Jun 30) $15
L — Life Member (age-based)
T — Transfer (attach form)
COAN — Change Address (new)
COAO — Change Address (old)
CON — Change of Name
CARDG — Gold Card Replacement $20
CARDP — Plastic Card Replacement $10