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Give a Gift Membership

This form is for GIFT memberships; Click here if you would like to personally become a new local member or click here if you want to renew an existing membership.

Select Membership Level *

$50 - Household

$35 - Public or Private School Teacher (name of school must be provided)

$20 - High School or College Student

Name of School (for teacher memberships)

Contact Information

Your Name *

First Name

Last Name

Recipient’s Name *

First Name

Last Name

Recipient’s Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Recipient’s Email

Verify Email

Recipient’s Phone

Heads Up, PVAS!

Upon completion of this form, the recipient will be automatically subscribed to our e-newsletter: Heads Up, PVAS! This newsletter goes out on the first and third Wednesday of every month. Please be sure they know to check their 'Spam' folder, or 'Promotions' tab if the newsletter cannot be found in their inbox.

Once they have received their first Heads Up, they can easily unsubscribe at anytime using the prompt at the bottom of the email. Please be assured that PVAS will not share yours or their email address for any reason.

Add 3% to my total amount to help cover the payment processing fees