Name: ________________________________________________
(Organization and Contact Person or Individual Member)
Address: _____________________________________________
City: _____________________ State/Province: __________
Zip/Postal Code: __________ Country: ________________
Phone(s): ______________________ Fax: _________________
E-Mail Address: ______________________________________
Organizational Membership Dues:
___ $50 Groups under 100 members
___ $100 Groups 100 - 500 members
___ $200 Groups over 500 members
___ For communities living in voluntary poverty (whatever can be given)
Individual Membership Dues:
___ $25 Individual Membership
___ $40 Household Membership
___ $75 Supporter
___ $100 Patron
___ $15 Low income Membership
Donations and membership fees to Consistent Life are tax deductible under United States law. Please submit all donations in U.S. currency.
Mail to: