Join or Donate Now
Mail Form to:
Diversity Center
PO Box 8280
Santa Cruz, CA 95061
.
Yes, I wish to establish or renew my membership with the Diversity Center!

Name: ________________________________________________________________
Address:_______________________________________________________________
                ______________________________________________________________
City, State, Zip:_________________________________________________________
Phone (daytime) _______________________________ (evening) _________________

e-mail address: __________________________________

 ___  I would like to volunteer time or talent to the Center.  Please call me.

Annual Membership                   Join the Proud Crowd!
                                                         Monthly Pledge
__ $15 Limited Income                __ $15
__ $40 Individual                         __ $25
__ $65 Family                              __ $50
__ $100 Sustaining                     __$100 Champion
__$250 Benefactor                      __$____$God(ess) of Diversity
__$500 Patron
 

Check Enclosed __  (Please make checks out to "The Diversity Center")

Or Pay by Credit Card

Credit Card ___ VISA ___ Mastercard
Number ________________________________________ Expiration date ___________________
Name on card __________________________________________________
Billing address (if different than above) _______________________________________________

Signature _________________________________________________________________________

__  Check here IF WE MAY PRINT your name in the Manifesto Newspaper or in our Web site.

Thank you for your tax deductable contribution.  The Diversity Center is a registered 501(c)(3)
non-profit corporation - Tax ID#: 77-0212967.