2026 Membership: PFLAG Grinnell/Poweshiek

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Please provide the following information for our records. This information will be maintained by the PFLAG Grinnell-Poweshiek Board of Directors and will be shared only with PFLAG National. In coordination with the PFLAG National fiscal year, the 2026 membership year runs from October 1, 2025 thru September 30, 2026.

Email *

Name (please include all household names to be included) *

Preferred pronouns

Physical mailing address (street, city, zip) *

Phone number (Optional: this will not be shared outside our group)

Membership / Donation Level *

$15 - Student Membership (annual)

$25 - Individual Membership (annual)

$40 - Household Membership (annual)

$50 and above - Over the Rainbow Membership (annual membership plus an additional gift)

Donation (no membership). Please note below if this gift is in honor of or in memory of someone so we can note this in our records.

Required

Is this a renewal or have you been a member of PFLAG before? *

Yes

I'm not sure

If making a donation in memory or in honor of someone, please provide that information here:

Total amount paid *

Payment options: Venmo @PFLAG-GPC; or Paypal to pflaggrinnellpoweshiek@gmail.com. *

Check (to PFLAG Grinnell/Poweshiek and mailed to 915 Summer St, Grinnell, IA 50112)

Venmo (@PFLAG-GPC)

Paypal (search pflaggrinnellpoweshiek@gmail.com)

Other:

Send me a copy of my responses.

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