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Membership
Contact Information
Name
*
First Name
Last Name
Name of Spouse/Partner (if applicable)
First Name
Last Name
Email
Verify Email
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Phone
*
Matching Gift
Does your company have a matching gift program? If so please list the name of the company above.
Membership Level
*
$1,000
-
Equity Member
$500
-
Shareholder
$250
-
Investor
$150
-
Banker
$75
-
Family
$50
-
Individual
$
Donation Schedule
One Time
Yearly
Consider making your membership annually recurring to ensure you continue getting all your benefits all year round. Recurring memberships also benefit CAC&G!