Please Join the Club

Gateway Parrot Club Annual membership dues: $20.00 per household.
Annual Membership is from January 1 through December 31

Please complete the form below.  Fields in bold/bold are required.

 

New/renewing member, or Update contact info only?	New   Renew   Info Update
First Name
Last Name
Address 1
Address 2
City
State
ZIP
Primary Phone ( numbers only )
Primary Phone Type	Select TypeCellHomeWorkOther
Second Phone ( numbers only )
Second Phone Type	Select TypeCellHomeWorkOther
Referred by
Other Family Members?
Email Address
Email (Confirm)
Preferred email body format	HTMLPlain Text
Preferred email attachment format	PDF-Adobe ReaderMS Word
Receive newsletter	Email Only - Save stamp, paperPostal Mail and EmailPostal Mail OnlyNot at all
Payment Method	Select Payment MethodPaypal OnlineCheck in MailOtherNone Required

The online payment option will appear on the following confirmation page.

Please include any additional information or questions...