Alumni Membership Program Registration Form

ALUMNI MEMBERSHIP PROGRAM

Registration Renewal

*Required Fields

*Name

__________________________________________________________

Title

__________________________________________________________

Organization

__________________________________________________________

*Mailing Address

__________________________________________________________

*Mailing Address (cont'd)

__________________________________________________________

*City, State, Zip

__________________________________________________________

*Phone

__________________________________________________________

Fax

__________________________________________________________

*Email

__________________________________________________________
your membership confirmation will be sent to this email address

*City/State of Your Training

_____________________________________not sure of location?____

*Month/Year of Your Training

_____________________________________not sure of date?_______

Alumni from workshops prior to 2001 should contact The Center at alumni@tgci.com

My Membership account has expired.
Please re-activate my Membership for:

My Membership account is still active.
Please renew my Membership for:

1 year for $375
2 years for $575
3 years for $725

1 year for $250
2 years for $450
3 years for $595

Promotional Code ________________

Please indicate method of payment:

Check #_________________ or Purchase Order #______________________
payable to The Grantsmanship Center

Credit Card #___________________________________Expires _______________
Visa or Mastercard only

Name on Card (PLEASE PRINT)_____________________________________________

Signature____________________________________________________________

Please print out this form and send with payment to:

The Grantsmanship Center Membership Program
P.O. Box 17220
Los Angeles, CA 90017

Credit card orders may be faxed to (213) 482-9863

Questions? E-mail us at alumni@tgci.com or call (213) 482-9860