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Pelican Island Preservation Society
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Please print out this page. When printing this page from your browser, you will only need to print the first page. The second page will only include the additional information below this application, about making a payment by credit card, using PayPal. To make a membership dues payment or donation using PayPal, please see the information below the application and click on the "Make a Donation" button.

Please check one

[   ] Student (under 18) - $5 per yr

[   ] Contributing - $50 per yr

[   ] Individual - $10 per yr

[   ] Corporate/Business - $100 per yr

[   ] Family - $15 per yr

[   ] Supporting - $250 per yr

[   ] Life - $500 one-time donation

Name(s)

______________________________________________________

Company

______________________________________________________

Address

______________________________________________________

City/State/Zip

______________________________________________________

Phone (Day)

______________________

Phone (Eve)

______________________

eMail

______________________________________________________


If you are a current member, you do not need to fill in an application form, unless any of your contact information has changed. If not, just send your dues to the address below. If this is a gift membership, please fill out both sections.

PIPS is a 501(c)3 not-for-profit organization and donations are tax deductible, to the extend allowed by law.


[   ] Gift Membership Information
If this is a gift membership, please fill out both sections.

Name(s)

______________________________________________________

Address

______________________________________________________

City/State/Zip

______________________________________________________

Send completed application & dues to:
PIPS Membership
PO Box 1903, Sebastian, Florida 32978-1903


Make a Donation Using PayPal!

Click on the "Make a Donation" button below if you would like to use PayPal to make a membership dues payment (new or renewal) or general donation. When you click on the button, you will be taken to the PayPal payment processing form where you need to fill in the amount of your payment/donation. If you are making a general donation, please fill in any amount you wish and include a comment under the "Optional Instructions" that this is just a general donation. Otherwise, please fill in the amount that corresponds to the membership level of the dues payment you would like to make. In this case, please include a comment about which level of membership this payment is to be applied to.

For more information about using PayPal, please click here.
Thank you!


Membership Categories:

Student (under 18) - $5/yr
Individual - $10/yr
Family - $15/yr
Contributing - $50/yr
Corporate/Business - $100/yr
Supporting - $250/yr
Life - $500 one-time donation

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