Support GLFD > Become a Member

Membership Level (membership status extends for one year beyond current expiration date)

• ___ $ 50 Friend Membership
• ___ $250 Advocate Membership
• ___ $500 Philanthropic Partner Membership
• ___ $___ Other

Member RECOGNITION OPTIONS:

• ___ 100% of this gift is a charitable contribution and no benefits are required
• ___ This donation is for a gift membership and the recipient is detailed below
• ___ Please make this donation anonymous
• ___ Please recognize me in print as:

PAYMENT OPTIONS:

• __ Check enclosed (payable to the Gay & Lesbian Fund for Dallas)
• __ Charge the full amount: _ MASTERCARD _ VISA _ DISCOVER _ AMERICAN EXPRESS
• Credit Card #
• Expires
• Name
• 3-digit security ID

ESTATE PLANNING BENEFITS:

• __ I/we would appreciate information on the benefits of Planned Giving
• __ I/we have provided for the Gay & Lesbian Fund for Dallas through our Estate and wish to be recognized in its Annual Report.

REQUIRED – DONOR INFORMATION:

• Name
• Partner/Spouse
• Address
• City/State/Zip
• Phone
• Email
• Can We Add You as a GLFD Facebook Friend (y/n)?
• Interested in GLFD Volunteer Opportunities (y/n)?
• Name of Other Non-profits That You Actively Support?

GIFT RECIPIENT INFORMATION (if applicable):

• Name
• Partner/Spouse
• Address
• City/State/Zip
• Phone
• Email

If you prefer, print this form and return along with payment to: Gay and Lesbian Fund for Dallas, Attn: Mbship, 3824 Cedar Springs, Box 371, Dallas, Texas 75219