Gift Membership Donation

Gift Membership Donation
Your Name*

First NameLast Name
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Phone Number
Your E-mail
Gift Recipient's Name*

First NameLast Name
Gift Recipient's Partner Name (will appear on card)

First NameLast Name
Gift Recipient's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I would like the membership card delivered to:*

myselfthe recipient
An acknowledgement letter will accompany the membership card. Would you like to add a personal message along with this letter (please add it below)? If you do not want a letter to be sent, please state that below.
Member Levels

Member/Donors

Friend $60 - $119
Explorer $120 - $274
Patron $275 - $999
Benefactors Circle

Benefactor $1,000 - $2,499
Advocate $2,500 - $4,999
Visionary $5,000 - $9,999

Amount*

USD

Member Levels