LOTUSLAND - GIFT MEMBERSHIP

Membership Level:
___Level I$75___Garden Patron $2500
___Level II$125 ___Garden Benefactor$5000
___Level III $500___Garden Sponsor $10,000 & above
___Level IV $1000

TO: name of gift recipient(s): Please Circle: Mr. / Mrs. / Mr.& Mrs. / Miss / Ms./ Dr. / Dr. & Mrs.
_________________________________________________________________________
Address:__________________________________________________________________
City, State, Zip:_____________________________________________________________
Telephone:_____________________________ Email: _____________________________

FROM: Please Circle: Mr. / Mrs. / Mr.& Mrs. / Miss / Ms. /Dr. / Dr. & Mrs.
_________________________________________________________________________
Address:__________________________________________________________________
City, State, Zip:_____________________________________________________________
Telephone:____________________________ Email: ______________________________

Is there a message to be sent with gift membership? [birthday/anniversary/other] __________
__________________________________________________________________________

Please send gift membership package and announcement card:
 to recipient   or    to me and I will deliver to recipient

Please send renewal for gift membership:    to me  or     to recipient.
*Total Amount Enclosed: $________   *Memberships are tax deductible

Payment options:
 Check enclosed payable to Ganna Walska Lotusland Foundation
 Visa     Mastercard    American Express

Account No.:___________________________________________        Exp:______________
Signature:_________________________________________________________________

[charges cannot be processed without accurate expiration date]

Please allow 2 weeks to process membership- or call 805-969-3767 if special needs apply.

Mail or fax printed form to:
Ganna Walska Lotusland Foundation
Attn: Membership Department
695 Ashley Road
Santa Barbara, CA 93108-9939
Fax: (805)969-4423