Gift Form – Appalachian Mountain Club

Membership Level*

Individual - $50
Family - $75
U-30 (under age 30) - $25
Senior (age 70+) - $25

NOTE: Family membership includes 2 adults and all children under age 21 in your household.

Do you want to identify a recipient?*

Yes, I’ll give their address below
No, I’d like a blank gift membership

Hidden

How would you like the gift delivered?

Postal mail
Email

Where would you like us to send the Gift Note Card?*

Send it to me
Send it to my recipient

Would you like the recipient to know who you are?*

Yes
No

How would you like your name to appear on the Gift Note Card?

example: "Mom and Dad" "Sally" "Your best friend")

Message

Write a short note for us to include the gift notecard. (example: "Happy Birthday!" "Merry Christmas" "Congrats!")

My Contact Information

Name*

Email*

Phone

Address*

Gift Recipient Information

Recipient Name*

Recipient Email*

Recipient Phone

Recipient Address

Recipient Address Line 2

Recipient City

Recipient State / Province / Region

Recipient Zip / Postal Code

Recipient Country

Second Adult: First Name

For Family Membership

Second Adult: Last Name

For Family Membership

Second Adult Email

For Family Membership

Payment Information

Billing Information*

Billing Information matches Contact Information

Payment Information*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Total

$0.00

Order Mode

Test
Production

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Membership Gift

My Contact Information

Gift Recipient Information

Payment Information

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