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Seattle Gay Couples
Membership Application
Required Fields are in RED
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MEMBERSHIP TYPE / PAYMENT OPTIONS
You do not need to create a paypal account to make a one-time payment via your Credit Card or Bank Account. Look for instructions on the PayPal window.
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| Membership Type: |
Paypal Payment Gateway |
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ACCOUNT SETUP
Email Address: |
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Your email address is your SGC Logon (Please check address carefully)
Password: Re-enter Password: |
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Continue to Registration section
REGISTRATION INFORMATION |
| Additional Email Address: |
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First Name Last Name |
| Partner 1: |
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| Partner 2: |
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Format example "John and Joe" |
| Partners First Name's: |
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| Address: |
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| City, State, Zip * |
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Phone / Alternate Phone:
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| Anniversary Date: |
format (MM/DD/YYYY) |
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Continue to Membership section
MEMBERSHIP DIRECTORY (Optional) |
Display Biography Listing
in Membership Directory: * |
Yes (or leave blank for No)
Biography listing includes your first names, anniversary date and city. |
Biographical Detail or
Personal Interests:
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Contact Information you wish to share with other members:
(Please enter specific details such as your address / email. The system will not copy data from other fields.)
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Participate in 3x3x6 Dinner Group?
[Find out more]
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| How did you hear about SGC?: |
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Membership Agreement Confirmation:
(Both partners, individually need to consent to this agreement.) |
First Partner (as listed above): Second Partner:
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