City of Victoria Form Center

2. 
4. First Name
5. Last Name
7. Mailing Address
8. Apartment or Suite Number
10. City
11. State
12. Zip Code
14. Email
15. Phone Number
16. Ext.
18. Membership Level

    1. Individual: $25.00 per year
    2. Family: $50.00 per year
19. Corporate Sponsorship Level

    1. Bronze Sponsorship: $250.00 - $499.00
    2. Silver Sponsorship: $500.00 - $999.00
    3. Gold Sponsorship: $1,000.00 - $1,999.00
    4. Platinum Sponsorship: $2,000.00 and above

21. Keep Victoria Beautiful is a 501(c)(3) organization and your donation is tax deductible. Once payment is received, we will send you a letter for your records.

23. Please make payable to Keep Victoria Beautiful.

    Send membership payment by mail to:

    Keep Victoria Beautiful
    P.O. Box 1758
    Victoria, Texas 77902

    Please print out and include this completed form when sending membership dues.

25. I am interested in

    1. Helping with clean ups
    2. Organizing a small clean up
    3. Helping with a beautification project

    Let us know if you would also like to volunteer with us for various events held throughout the year!

Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit Submit and Print

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