Become a TBTN Shooting Star

Become a TBTN Shooting Star

TBTN Shooting Stars sustain the work of TBTN. Membership options are $35 per year, $100 per year, or a Lifetime Membership with a one-time donation of $1000. All Shooting Stars have access to special events. Membership fees are tax deductible. Please note in completing this form, you understand and agree that TBTNF may use your submission and data as part of its aggregate reporting, operations, and internal review. TBTNF does not sell your personal data or contact information to any 3rd parties.
Name*

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Email*

Confirmation Emailexample@example.com
Mobile Phone

Area CodePhone Number
Phone Number (US Country Code = +1; Canada = +1; Australia = +61; UK = +44; find other Country Codes at countrycode.org/)*

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Your School, Employer, or Most Closely Affiliated Organization*
Put None if not affiliated.
Address*

Street Address

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I want to be a Shooting Star for Take Back The Night Foundation because . . . (check all that apply)*

I'm a survivor.I want to support survivors.I want to work to end sexual violence.I enjoy participating in TBTN Events.
I have attended approximately this many TBTN Events:*
Demographics

This information is needed for our non-profit status and other metrics, including those established by grants, governmental agencies, and other NGOs.
I identify as:*

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My preferred pronouns are:*

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I identify as:*

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My age is:*
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Would you like your name to be listed on the TBTNF website as a Supporter/Member?*

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Individual Membership Fee - Yearly*
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TBTNF Engaged Membership($35.00 for each year)
Become an Engaged Member Shooting Star for TBTNF! Annual fee of $35 as a donation to the Foundation. Renews annually. Can be discontinued at any time. Perks: Get newsletter and automatic access to Global Virtual.

TBTNF Involved Membership($100.00 for each year)
Become an Involved Member Shooting Star for TBTNF! Annual fee of $100 as a donation to the Foundation. Renews annually. Can be discontinued at any time. Perks: Includes access to 20% discount on TBTN gear, access to TBTN playlist of empowering songs, access to TBTN Event Kit (including poems, survivor stories, and more).

Lifetime Individual Membership($1,000.00 one-time payment)
Become a Lifetime Shooting Star for TBTNF for a one-time fee of $1000 as a donation to the Foundation. Perks: Includes access to 20% discount on TBTN gear, access to TBTN playlist of empowering songs, access to TBTN Event Kit (including poems, survivor stories, and more).
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