Membership Application

For Gift Memberships, please give contact information for person recieving the gift. Email wizard@tucsonvalleyofthemoon.net if you would like Valley of the Moon to send the recipient a special email message from Valley of the Moon.

Membership Level:

Individual Membership ($35.00)

Family Membership ($60.00)

Lifetime Membership ($500)

The Gift of Kindness Individual Membership ($35.00)

The Gift of Kindness Family Membership ($60.00)

The Gift of Kindness Lifetime Membership ($500)

Check here if you'd like your membership to automatically renew.

First Name: Last Name: Email: Home Phone: Home Address: City: State: Zip: -

I would like to make an additional contribution: