Become a Member Today! 

Friends of Bellingrath Membership Form

 □ New Membership          □ Renewal          □ Gift     

      

(Mr./Mrs./Ms.)__________________________________________  ______________________________                                                                                                  Date of Birth

(Mr./Mrs./Ms.)__________________________________________  _______________________________                                                                                                  Date of Birth
Address________________________________________________________________________________

 

City: __________________________________  State: _________________  Zip: ___________________
 

Telephone: ________________________________  Email: _____________________________________
 

Children's Names & Date of Birth

1.     _______________________________________________________ DOB: ___________________

2.     _______________________________________________________ DOB: ___________________

3.     _______________________________________________________ DOB: ___________________

4.     _______________________________________________________ DOB: ___________________

5.     _______________________________________________________ DOB: ___________________   

(Family, Patron & Belle Camp memberships may include up to 2 adults and 5 children under the age of 18 in one household.)

I am a Facebook Fan Bellingrath Gardens and Home.          □ YES               □ NO
 

Membership Levels                                      

General Membership Levels:       □ Individual $50       □ Couple  $75      □ Family $100            

Patron Levels:                           □ Rose  $150           □ Azalea  $250            

Belle Camp Society Levels:         □ Silver $500           □ Gold $1,000      □ Platinum $2,500

Total Amount Enclosed $_________________________ 

               □ Check Enclosed (Payable to Bellingrath Gardens and Home)                        

           □ Visa        □ MasterCard     □ Discover      □ American Express

Credit Card Number: __________________________________Exp. Date: __________
 

Signature: ______________________________________________________________  

Form may be printed and mailed with payment to:            

Membership Office           

12401 Bellingrath Gardens Road          

Theodore, Alabama  36582           

Phone:  800.247.8420 / 251.973.2217 ext. 165             

Fax  251.973.0540

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