| YES! I want to support the ministries of GLAD Alliance, Inc. by becoming
a member. You can make your membership donation on-line via PayPal.
Print this page, fill out the form and mail to the address below.
| NAME(s) |
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| ADDRESS |
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| City/State/Zip |
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| Telephone |
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| E-Mail |
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| Amount Enclosed: |
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| Membership Contribution - Please check one below. |
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$1,000* Pink Triangle Member ( $500 bi-annually / $250 quarterly) |
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$500* Rainbow Member ($250 semi-annually / $125 quarterly) |
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$250* St. Andrew's Cross Member ($125 semi-annually / $62.50 quarterly) |
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$100* Red Chalice Member ($50 semi-annually / $25 quarterly) |
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$60 Couples Membership |
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$35 Individual Membership |
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$15 Low Income/Student Membership |
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* May be made on behalf of two persons. |
| Payment options: |
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check enclosed |
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semi-annual reminder |
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quarterly reminders |
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| Additional Support |
| $ |
Contribution to Chuck Carpenter Leadership Fund (to assist potential leaders in
attending GLAD events) |
| $ |
Contribution to Endowment Fund (to sustain the future work of GLAD) |
| $ |
Contribution to Allen Harris Endowment Fund (to sustain the future work of Open &
Affirming Ministries) |
| Your check or money order payable to "GLAD Alliance" will be endorsed in the
same manner to preserve confidentiality. Mail to:
GLAD Alliance
P.O. Box 44400
Indianapolis, IN 46244-0400
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| GLAD Alliance is a not-for-profit organization. Your contribution is tax deductible. |
 Our mailing
list is confidential.
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