APGF - Membership Application

A/PGF MEMBERSHIP APPLICATION
Membership*

NewRenewal
Length of Membership*
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birthday MM/DD*
Phone Number*

Area CodePhone Number
E-mail*
If joining as a couple please enter partner name
Partner Birthday MM/DD
Partner Phone Number

Area CodePhone Number
Partner Email Address
Check Committee (if you are interested in helping)

Membership OutreachSpecial EventsCulture and EducationPublicationsWebRAPNone
Can you open your home to host events*
If yes to the previous question, what can you host?

Movie NightPool PartyKaraokeRAPGame Night
How did you hear about A/PGF*

WebFriendFacebookGay Pride ParadePast MemberRenewing MemberOther
Interests
Comments
I certify that I am 18 years of old or older*
I agree to the Code of Conduct as being a member of A/PGF*
Memberships
prevnext( X )
1 Year Individual Membership$30.00

2 Year Individual Membership$55.00

1 Year Couple Membership$50.00

2 Year Couple Membership$85.00

Total $0.00
Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
Should be Empty: