Los Angeles Chapter

RENEW OR DONATE

You may join or renew your membership with GLSEN Los Angeles at any of our pre-set levels, or you can choose any amount you like. If you'd prefer to talk with someone at GLSEN about other forms of giving including Corporate Sponsorship, Donations of Stock, or giving in your will, please contact the Acting Director of Development, Eric Douglas at edouglas@GLSEN.ORG.

Choose Your Donation Level

AMOUNT

$35

$50

$75

$100

$250

$500

$1000

TYPE

One-Time Donation

Monthly Donation

Your Information

First Name

This donation is

Last Name

In Honor Of:

A Gift Membership For:

Address Line 1

First Name

Address Line 2

Last Name

City

Address Line 1

State/Zip Code

Address Line 2

Daytime Phone

City

Email Address

State/Zip Code

Donation Method

Card Type				Expiration Date

Card Number				Card Verification No. (3-digit # on back of card)

Cardholder's Name

GLSEN is a 501(c)(3) non-profit organization. All donations to GLSEN are tax-deductible to the extent allowed law. Please note that monthly donations will continue until we receive notification from you to stop the monthly contribution. You may also notify us at any time to either decrease or increase the amount of your gift. You may contact the Development Department by email at: onlinedonations@glsen.org.

		I request that GLSEN not publish my name in its Annual Report and/or other publications.

		I request that GLSEN not trade my name with other organizations.

	Please enter any additional comments or instructions below:

	GLSEN respects your concern for security on the Internet. You are submitting on a secure connection.