GGI Membership Application Form
Section (1)-Contact Information: –
Name: ______________________________________________________________________________
Email: _________________________________________ – *
Phone Number:* _________________________________________ –
Address: _________________________________________
Annual membership fees*
Section (2) Membership Level: Charge fees as follows, with discounts for seniors,
students, individuals with special needs, or military personnel for relatives who are already approved GGI members.
2. One Day Membership for a visiting family member once approved by a GGI Committee staff – $25.00 for a Plus -1 Pass (A P1P is one day membership entry only for 24 hours )
2a. Basic Membership – $100.00 annually ($8.33 monthly)
2b. Bronze Membership- $175.00 annually ($14.58 monthly)
2c. Silver Membership- $249.00 annually ($20.75 monthly)
2d. Gold Membership- $495.00 annually ($41.25 monthly)
2e. Honorary Membership – is extended to sponsors, donors, and contributors who provide annual support exceeding $5,000.
Membership & Contributions
Acceptable Payment Methods are as follows: Credit Card (Visa, Mastercard, Amex, Discover), Money Order, Certified Personal Checks, Zelle, Cash App, Venmo, Cash, and Chime. Credit Card Information (if applicable): Card Holder
Name (as it shows on the card ) ___________________________________________________________
Card Number:____________________________________________________________________
Expiration Date:______________________________ Security Code:_____________________
Card Zip Code:______________________________________
MO /Cert Check Information (if applicable):
Purchaser Name ______________________________
Check Number: ______________________________________- Check Amount:_________________
Additional Information
How did you hear about GGI?_____________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
What motivated you to join GGI?__________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
*Terms and Conditions: –
*I understand that membership is non-transferable
and non-refundable.* *I agree to abide by GGI’s rules,
regulations and all GGI By Laws.
Print Name ______________________________________________________________________
Signature: _______________________________________________________________________
Date:___________________
Additional Application Submission Information
*Please submit this application form via email to givinggaminginitiative@gmail.com
*If paying by credit card or other digital method, please click the “Submit” button
below to complete your application.
*If paying by Money Order / Certified Check, mail your payment with your
application form to the following address:Giving Gaming Initiative, INC –
Membership Program Division 411 Overlook Turn Conyers, GA 30012
Submit