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$1000 Leadership Level
*
$
$
x $1,000.00
One Time
Recurring
Please enter "1" in the above box
Leadership Welcome Packet?
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YES - Send me a membership packet in the mail
NO - Just send me my membership card
$
$
One Time
Recurring
* As a new member, you’ll receive a membership card with your 10% merchandise discount code, our Annual Report, a condor brochure, and a 4x6 condor photo.
Bronze Plaque?
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YES - Send me a CONDOR bronze plaque
YES - Send me an EAGLE bronze plaque
NO - Do not send me a bronze plaque
$
$
One Time
Recurring
Name
*
$
First Name
Last Name
$
One Time
Recurring
Partner or Spouse Name
*
$
$
One Time
Recurring
Address
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Address Line 1
Address Line 2
City
State
Zip
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One Time
Recurring
Email
*
$
$
One Time
Recurring
Phone
*
$
$
One Time
Recurring
Anonymous
*
$
Yes
No
$
One Time
Recurring
Notes for us?
*
$
$
One Time
Recurring