Order now: info@hexapong.com / 602.439.0786
Navigation Menu

United States Hexapong Association (USHA)

Membership Form

Individuals signing up as members to USHA will be provided with discounts on specified items sold on this site by Hexapong. Information given is solely Hexapong data and will not be given or sold to any other entity.

 

PLEASE NOTE: All membership applications are approved manually and activated once payment has been confirmed.  You will receive an email from us when your membership is ready for use on this site.  Thank you!

Your membership card will be available within your member profile page.

 

First Name*:
Middle Name:
Last Name*:
Username*:
Password*:
Re-enter Password*:
Gender:
 
Street*:
Apt./Suite No.:
City*:
State*:
Zip*:
Phone*:
Fax:
Email*:
Membership fee: $20