Payment Information

Debit/Credit Card- (Once you submit your application, you will be directed to Paypal.com to complete your transaction securely. You do not need an account to pay with Paypal.)

Amount Due:



Mail this completed form and payment to:

Empower Me! ATTN: Empower Me! Professional Network Membership P.O. Box 863, Alpharetta, GA. 30009-0863 or fax to: 253-559-4028

Email and fax applications will be accepted only when paying by credit card (Paypal) or online check. Application confirmation will be sent via email so please ensure you list the correct email address. Please allow two weeks for processing from the date of receipt of your application.

No cash will be accepted. One application per person. Membership is valid for one year and non-refundable. Renewal is not automatic. The entire cost of your membership cost is used to underwrite the EMPN. Your membership is national. If you choose, you may apply for membership to a local chapter. Each chapter is run independently and has its own guidelines, agenda and protocol. However, all chapters are governed by the by laws of the national EMPN office. To gain the most benefits from the network, you should affiliate with a local chapter if available. Membership fees are non-refundable. Returned check fee is $35. All information is held confidential and will not be sold to third parties. Only our approved sponsor companies will be sending you information about their services or products. You must supply your membership number to receive member discounts. EMPN does not tolerate spamming or false representation of EMPN or Empower Me! Any member found violating our policies, will have their membership terminated immediately. Please review your membership rights and responsibilities when you receive your new member packet.



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Electronic Signature