Membership Application / Renewal

Application for Membership or Renewal?(*)

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MEMBERSHIP CATEGORY:
Regular Membership $50 Annual Contribution
Sustaining Membership $75 Annual Contribution
Contributing Membership $100 Annual Contribution
Donor Membership $150 Annual Contribution
Benefactor Membership $250 or more (use additional donation below)
Benefactor Membership $1,000 Annual Contribution
Benefactor Membership $2,500 Annual Contribution
Commercial Membership $100 Annual Contribution
Donation Only...

Membership Types

Regular Membership - 50.00 USD Sustaining Membership - 75.00 USD Contributing Membership - 100.00 USD Donor Membership - 150.00 USD Benefactor Membership - 250.00 USD Benefactor Membership - 1,000.00 USD Benefactor Membership - 2,500.00 USD Commercial Membership - 100.00 USD TEST AMOUNT - 1.00 USDDonation Only Invalid Input

Additional Donation

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Total

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Your Name (s) (as you want displayed in the Directory)(*)

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Zip

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Phone

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Please supply your Geneva Area Address if different from above. Please include complete address, city, state, zip. Thank you.

Geneva Area Address

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Geneva Area Phone

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Pier Number (if none, use LG, F, WB, etc)

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Subdivision or Association (If any)

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Estate Name (ex. “Heavenly Acres”)

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Do you have a message or special request / instructions for GLA?

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