Membership Form

2008 LOFT Membership Form

Due to the nature of our volunteer organization, we are not able at this time to renew each membership by its anniversary date. Please note that The Loft's member year runs from January to December. We conduct a yearly membership drive that starts in December and runs though February. We apologize that we are not able to reflect each members' anniversary date and ask that you respond to our yearly request for membership renewal when you receive it.

*Required Fields

*Name 1:

Name 2:

*Address:

*City:

*State:

*Zip:

*Name 1 E-mail:

Name 2 E-Mail :

Day Phone:

Evening Phone:

*Credit Card #:
(Visa or MasterCard)

*Expiration Date:

*Name on Card:

Personal Membership Levels

$20 Student/Senior

$40 Individual

$60 Household

$100-299 Pride Amount:

$300-499 Sponsor Amount:

$500-999 Patron Amount:

$1,000-1,499 Gold Triangle Amount:

$1,500-1,999 Platinum Triangle Amount:

$2,000-4,999 Executive    Amount:

$5,000 and up Leadership Amount:

Business Membership Levels

$300 Basic $1000
    Corporate Sponsor

$500 Business Patron $5000 Business
    Leadership Council

New Membership Renewal

*How did you hear about the online Membership form?

Other:

It is The LOFT's policy not to exclude anyone from membership based on ability to pay, as approved by the Loft's Treasurer and Secretary.

Your membership card will be mailed in 4-6 weeks.