Desert Tortoise Council
Membership Application

Please type or print

	NEW_____ RENEWAL______ CHANGE OF ADDRESS _______
DATE:	_______________________________________________________
NAME:	_______________________________________________________
PHONE:	_______________________________________________________
ADDRESS:	_______________________________________________________
CITY:	_______________________________________________________
STATE:	_______________________________ , ZIP: __________________
COUNTRY:	_______________________________________________________
EMAIL:	_______________________________________________________

To Pay By Check Print This Form and Mail to the Address Listed Below; to pay online through our secure server, click the button next to the appropriate membership level

Membership Level

( __ ) Regular ($30.00 per year)

( __ ) Organization ($125.00 per year)

( __ ) Lifetime ($500.00 one time donation)

( __ ) Student ($20.00 per year)*

(___) Donation

*Student memberships require endorsement of student's Advisor or Major Professor.

Please Check Preferred Delivery Method for Desert Tortoise Council Newsletter

( __ ) pdf via e-mail

( __ ) E-mail notice for Webpage viewing

( __ ) Hard Copy Newsletter

Make checks or money order payable to the DESERT TORTOISE COUNCIL and send with the application to:

Desert Tortoise Council
P.O. Box 1568
Ridgecrest, CA 93556

The Desert Tortoise Council does not release its membership list

back to membership

Desert Tortoise Council Membership Application

Desert Tortoise Council
Membership Application