Annual Pledge:
Individual: $5/mo
Household: $10/mo
Please fill all blank spaces. If no response, put "none".
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indicates required
Name:
Email:
Comment:
First Name
Last Name
Email Address
*
Type of Membership
Individual (self only)
Family (all members)
Student/Youth (under 22)
Payment Schedule
One Yearly Payment 1X/Year
Monthly Auto Deduction
