Grand Canyon Association Membership Application

Grand Canyon Association
Membership Application

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Grand Canyon Association
Membership Form

You can become a member by calling 800-858-2808 or fill out the form below, print it and fax or mail it to:
Grand Canyon Association
Membership Office
P. O. Box 399
Grand Canyon, AZ 86023-9984
Fax: 520-638-2484

Name:
Address:
City:
State:
Zip Code:
Country:
Phone (day):
Phone (night):
Email:

Please send me updates on GCA activities via email

Enclosed are my annual dues of:

Individual - $35	Guarantor - $500
Family - $50	Grand Circle - $1,000
Contributor - $100	Canyon Society - 2,500
Sponsor - $250	Donation $

Please do not send me any premiums. I want my membership to be 100% tax-deductible. I understand that I will receive Canyon Views, as well as discounts on merchandise and selected Grand Canyon Field Institute courses.

Payment
Enclosed is my check for:
Charge my (Check One):

American Express

Visa

MasterCard

Account #: Exp:

Signature:______________________________________________

For Contributor and above only:
Please bill me in installments

monthly

quarterly

semiannually

Enclosed is my first installment of $

Please do not make my name available to other non-profit organizations.

Please review this form before you print it to mail.

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