Gift Membership

The Gift That Keeps On Giving

To purchase a gift membership, simply complete the form below and submit your secure payment. We will then send a personalized gift certificate (shown at right) & application kit to you or the recipient within 5 to 7 business days. Please note that we CANNOT process the membership until we receive a completed application from the recipient.

I wish to purchase a Gift Membership at the following level*
- Classic - $3,000
  (Individual)
- Classic - $4,000
  (Couple)
- Bronze - $5,000
  (Individual)
- Bronze - $6,500
  (Couple)
- Silver - $10,000
  (Individual or Couple)
- Gold - $25,000
  (Individual or Couple)
*Please note, a one-time $75 administrative fee will be added to your total at checkout.

Recipient Information
Gift Recipient Name*
Prefix First Last
Gift Recipient Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Billing Information
Gift Giver Name*
First Last
Email*
Phone
Comments or Questions
Cardholder Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Must match EXACTLY to card being used.
Payment Info*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
One-Time $75 Administrative Fee
Total to be charged
$0.00

Gift Membership

The Gift That Keeps On Giving

Gift Membership

Recipient Information

Billing Information

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