Please print this page, fill out the form, and submit it with a check for $5.00 (or $75 for a lifetime membership) made payable to The Charlotte Perkins Gilman Society. Please mail to:
Overseas members: Please contact Robin Cadwallader regarding membership fees and payment. Please note: Payment must be in U.S. dollars.
Name: ________________________________________________________
Address: ________________________________________________________
Phone: ________________________________________________________
Email Address: ________________________________________________________
I enclose (please select one):
___ $5.00 for a one-year membership
___ $75 for a lifetime membership
I have also enclosed an additional gift of $_______.
$______ Total amount enclosed
Check one: ______ new member ______ renewal