One moment please...
2021-22 Membership Form - pay in installments

We offer installment payments for those joining at the Member Plus Level ($1,100) no later than September 30, 2021 and paying via PayPal. The total payment of $1,130 includes $1,000 for the grant, $100 for operating costs, and $30 in PayPal processing fees. To join, please complete the form below authorizing payment in four monthly installments of $282.50.

CONTACT INFORMATION

First Name
Last Name
*

MEMBERSHIP PLUS VIA INSTALLMENTS
The Membership Plus level of $1,130 includes $1,000 to fund the grant, $100 to help off-set operating costs of our all-volunteer organization, and $30 to cover credit card processing fees.
*
Monthly
*

Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country

*
This directory will be for the exclusive use of our members and is not to be used for commercial or solicitation purposes.
*
This will allow you to receive our monthly newsletter and other important mailings.
I WOULD LIKE TO VOLUNTEER!

First Name
Last Name
*
Media Release: