Join GLIL

GLIL will be glad to keep you informed of our activities and to accept your contributions to support our efforts. Please fill out the form below. Only the fields marked with (*) are required.

Mr/Ms/Mrs/Dr:
Your First Name:
Your Last Name:
(*) Your E-mail Address:
Address:

City:
State:
ZIP:
Country:
Phone:
Fax:
Please notify me of...
Social events Political action
Media releases Volunteer Opportunities
Other (please detial below)

Please enter any comments or questions. If you like, enter a brief description of yourself or your interests.

Comments:

If you wish to make a contribution, select a contribution level. Please send your contribution, payable to: Gays and Lesbians for Individual Liberty,P.O.Box 65743 Washington, DC 20035. (GLIL is a 501(c)(3) registered non-profit corporation.)

Contribution Amount:
 Associate Member ($ 20)
 Member ($ 50)
 Donor ($ 100)
 Sponsor ($ 250)
 Patron ($ 500)
 Benefactor ($ 1000)
Other:


Click to subscribe to GLIL's e-mailing list


Return to the GLIL home page.

This Page Last Updated on
Saturday, 6 July, 2002 21:07