Organization Membership Application

If you belong to an organization, community group, church, garden club, or school and believe everyone has a right to breathe clean air and want to get involved, your group can join GASP today as a member! Our recommended* nonprofit membership dues are:

$25 (budget: less than $49,999)
$50 (budget: $50,000–$99,999)
$75 (budget: $100,000–$249,000)
$125 (budget: $250,000–$499,000)
$250 (budget: $500,000–$999,999)
$500 (budget: $1,000,000+)

* $5 minimum

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Membership Dues

$500 $250 $125 $75 $50 $25 Other $

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Contact Information

Organization Name

Street Address

Zip Code City State

Organization Email (Optional) Organization Phone (Optional)

Prefix (Optional) First Name Last Name

Email Home Phone (Optional)

(Optional)

Payment Information

Card Number

Expiration Date

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Membership Agreement

My organization supports GASP's mission to advance healthy air and environmental justice in the greater-Birmingham area and wishes to join as a member or renew our membership.

Eligibility

I am authorized to submit this form on behalf of my organization.

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