Please put a check next to the items you want visible on the public website.

Screen Name:
Member Type:
Name (Title):		Display Name (Title, First and Last)
Name (First):
Name (Last):
Email:		Display Email
Organization:		Display Organization
Group Name:		Display Group Name
Group Size		Display Group Size
Address (line 1):		Display Full Address
Address (line 2):
City:
State:
Zip:
Phone:		Display Phone
Phone2:		Display Phone2
Map Pin Placement:
Notes:	Display Notes