Lifetime Membership Form

Application for Life Membership

Applicants must be 21 year of age or older

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Membership

Life Membership ($1,250)

I'd like to help cover the transaction fees for my membership. My total amount will be $1,295.30.

Contact Information

Prefix (Optional) First Name Middle Name (Optional) Last Name Suffix (Optional)

Date of Birth (Optional)

Gender (Optional)

Street Address

Postal Code City State

Email Home Phone (Optional) Mobile Phone (Optional)

Yes, sign me up for email updates.

(Optional)

Employer Information

Occupation (Optional) Employer (Optional)

I am retired

Employer Matching

Enter your work email address to determine if your gift is eligible to be matched by your employer.

Work Email (Optional)

Payment Information

Card Number

Expiration Date

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Interests

Tell us your interests.

Volunteering

Cultural Programming

Learn German

Concerts

Tastings

Learn German

Additional Information

Spouse's Full Name, Email Address, Phone # (Optional)

Signature

Today's Date

Acceptance of Terms and Conditions

I confirm that the following statements are true

I agree to abide by the Deutsches Haus Charter, Bylaws and Resolution found on the website @ https://deutscheshaus.org/charter-by-laws/
I agree by entering my name above, I acknowledge my signature on this form.

Your donation will be securely processed.

Application process can take up to 4-6 weeks. Deutsches Haus is a Public Charity as defined in the Internal Revenue Code Section 501 (c) (3).

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