PFLAG PASADENA

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PFLAG Pasadena Membership Application


To become a member of PFLAG Pasadena, please print out and fill in the form below. 
Make a check payable to "PFLAG Pasadena" and mail it to us at:

PFLAG Pasadena
PO Box 125
Altadena, CA  91003

Or you can bring it with you to one of our meetings.  Even though we encourage people to join and contribute,
no one will be turned away for lack of funds.  Our meeting is open to everyone.

The mailing address listed above is used only for communication within PFLAG and is confidential.

Name:  (first and last)	_____________________________
Address:	_____________________________
City:	_____________________________
State:	____
Zip Code:	_________
E-Mail:	___________________

Basic Memberships (indicated with a *) are for one fiscal year (October 1st through September 30th).
To select, place a check in one of the boxes to the right.

Student*:  $25
Single*:  $35
Family or Couple*:  $50
Supporting:  $100
Patron:  $250
Benefactor:  $500

If you have any questions about filling out the application, please click on "Contact Us" in the menu at the top.