If you would like pay by check, to join the Dallas Goethe Center, please print out this form, and mark the level of membership desired.

Make checks payable to the Treasurer-Dallas Goethe Center, and mail with the completed form to the address above.

The membership year begins May 1st.

Type of membership: (please circle)
Student/Senior: $25.00
Regular: $50.00
Patron: $100.00
Sustaining: $200.00
Corporate: $500.00
Life Member: $1000.00

Valid for one household

Voluntary Extra Contribution: $...............................
Total Amount Enclosed: $................................
Date: __________
Member Name(s): ______________________________________________________________
Address: ______________________________________________________________________
City: ______________________________ State: _______ Zip/Postal Code: ________________
Phone Home: __________________  Office: __________________
E-mail Address: __________________
Newsletter via e-mail only: (___) Please check the space above if you wish to receive the newsletter via e-mail only.