Become a Member Member Name* First Last Date of Birth MM slash DD slash YYYY Partner Name First Last Date of Birth MM slash DD slash YYYY Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Phone*Primary Phone Type-Select-HomeMobileWorkEmail* To what email can we send membership-related information?Membership Level*-Select-Individual – $40Household – $75Senior – $35Full-Time Student – $0Supporting – $150Supporting – $250Supporting – $500Supporting – $1,500Newsletter Channel* Postal Mail Email Memberships come with an email newsletter. If you would like the extra service of a postal newsletter, an additional $5 fee will be added to your membership. How did you learn about the GAI?-Select-GAI Newsletter / Events EmailFacebook / Social MediaGoogle search / internetFriend / Family MemberLanguage ClassCultural ProgramRadioNewspaperOtherNoteMembership SubtotalAdditional Donation Total $0.00 Credit CardCard Details Cardholder Name EmailThis field is for validation purposes and should be left unchanged.