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 checks in U.S. currency. If you need to make your donation in another currency, please do it online.
Mail to: