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2011-12 MEMBERSHIP FORM:

Rainbow Richmond (RR) is an organization concerned with the care, treatment, and contributions of Gay, Lesbian, Bi-sexual, Transgendered, and Queer (GLBTQ) members of the Richmond, Indiana and surrounding communities.

Membership runs on an annual, calendar basis.

Dues are on a sliding scale: $5 - $20 per person or $10-30 per couple.

"More if you can, less if you can't."

Your membership dues help support RR's presence in the community. Funds are used for:

RR website,

RR advertising,

RR Pride Picnic,

4th Street Fair,

Attendance at out-of-town pride events,

Post Office box,

PFLAG support,

and many other things.

To join:

 complete this membership form at www.rainbowrichmond.org utilizing PayPal, or

 mail the form and your check or money order – made payable to, or

"Rainbow Richmond" to Rainbow Richmond, P.O. Box 34, Richmond, IN 47375

 give to any Rainbow Richmond officer/committee chair

Note: RR respects individual needs for privacy. Your contact information will not be shared with any person or organization outside of RR officers and committee chairs. Your contact information will be used to communicate with you about RR activities and issues, as well as relevant community events.

For questions or suggestions regarding membership or anything else, please contact us through our e-mail address (rainbowrichmond@gmail.com) or via telephone at 765-216-5428.

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Check one:  New Membership  Membership renewal

Name _____________________________________________________________________

Mailing address _____________________________________________________________

E-mail address ______________________________________________________________

Phone _____________________________________________________________________

Preferred contact:  Phone  E-mail  Snail Mail  No preference

Thank you for your support and involvement!

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