This form is intended for those who are unable to use our online membership web site powered by Wild Apricot. Please print out a hard copy of this form and type or print your information. Mail your completed form with a check or money order to the address at the bottom of the form.

Is this a new membership, a membership renewal, or a change of address?

NEW _____   RENEWAL ______  CHANGE OF ADDRESS _______

DATE: ___________________________________

NAME: _______________________________________________________________

PHONE: ______________________________________________________________

ADDRESS: ____________________________________________________________

CITY: ________________________________________________________________

COUNTRY: ___________________________________________________________

EMAIL: _______________________________________________________________


( __ ) Regular: $30.00 per year

( __ ) Organization: $125.00 per year
Name of Organization__________________________________________________

( __ ) Lifetime: $500.00 one time fee

( __ ) Student ($20.00 per year)*

(___) Donation  |   Amount___________________________________

*Student memberships require validation of registered student status (best obtained through the college or registrar's office, but a letter from an adviser will also be accepted).

When newsletters are published on the web site, you will receive an email notification with a link to the newsletter.

Make check or money order payable to the DESERT TORTOISE COUNCIL and send with your completed application to:

Desert Tortoise Council
4654 East Avenue S #257B
Palmdale, CA 93552

The Desert Tortoise Council does not release its membership or donor lists.

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