I AM:
 A New Member
 Renewing My Membership


Please Select a Membership Category:
  Membership
Category
Donation
Amount
Decals, Membership Cards,
Luncheon Tickets Provided
Single $50 One (1)
Couple $75 Two (2)
Business #1 $100 Three (3)
Business #2 $200 Five (5)
Lifetime $1,000 Six (6) per year for life
Elite $5,000 Ten (10) per year for life


Membership Information:
First Name: *
Last Name: *
Business Name:
Phone: *
E-mail: *


Mailing Address:
Address: *
City: *
State / Province: *
Zip / Postal code: *


Billing Address:
Same as Mailing Address
Address: *
City: *
State / Province: *
Zip / Postal code: *


Credit Card Information:
Credit Card Type:*
First Name: *
Last Name: *
Credit Card Number:*
(no spaces or dashes)
CVV2 Code:*   [what is this?]
Expiration Date:*
Comments/Questions:


Terms & Conditions:
  • Your membership will be valid for 1 year from today
  • Your card will be charged immediately

Fifty Club of Galveston County | PO Box 59 | Galveston TX 77553 | (409)763-8536