Online JBZS Gift Membership Form

Once you have completed and printed this form, please fax it to 616-336-3907 or mail it to:
Membership, John Ball Zoo Society, PO Box 2506, Grand Rapids, MI 49501-2506

Recipient Info

1st Adult Name:

2nd Adult Name:

Number of Children or Grandchildren:

Address:

City:

State:

Zip:

Phone:

Email:

Giver Info

Name:

Address:

City:

State:

Zip:

Phone:

Email:

Send the membership materials to:

Me (I want to give the gift in person) Recipient

Send the membership renewal notices to:

Me Recipient

Membership Categories

Membership Categories	Annual Membership Dues*	Amount
Founders League
Explorer	$1,000
Scientist	$500
Zoologist	$250
Beyond the Ticket
Beyond The Ticket Level 1	$250
Beyond The Ticket Level 2	$500

Membership Categories	Annual Membership Dues*	Amount
Basic Memberships
Naturalist	$150
Household Plus Two	$100
Household Plus One	$85
Household	$70
Grandparent Plus Two	$100
Grandparent Plus One	$85
Grandparent	$70
Individual Plus One	$55
Individual	$35

Payment Information

Credit/Debit Card:

Mastercard
Visa
Discover

Card Number:

Exp. Date:

Name on Card:

Signature: