Gift Membership Application

Bold indicates required fields

Thank you for purchasing a gift membership for Friends of the Zoo! Please provide the gift recipient's information below, as well as your own information at the bottom of the form.
Member/Cardholder Information
First & Last Name:
Choose one of the following:	Mr. Mrs. Ms. Dr.
First & Last Name of second adult living at same address:	Not applicable for Individual or Individual + 3 memberships
Choose one of the following	Mr. Mrs. Ms. Dr.
Mailing Address:
City:
State:	Louisiana Mississippi Texas Members MUST have a mailing address in Louisiana, Mississippi or Texas.
Zip code:
Phone:
Email:
Number of Eligible Family Members
Adults	Maximum of 2
Please select only one category	Children Grandchildren
Number of children OR grandchildren	Children/grandchildren must be ages 17 and under
Membership/Patron Choice
Membership Categories	Individual Individual plus 3 Household Honorary Keeper Safari Club Director's Circle
Option: Add Nanny/Caregiver for $15	Yes No
This is a gift from:
Full Name	This name will appear on a certificate sent with the gift membership packet.
Address
City
State
Zip code
Phone
Send membership packet to:	Recipient Me
Special Offer code

Memberships are non-transferable and non-refundable. Once issued, names on the membership can not be changed. A photo ID and valid Membership Card are required for FREE admission. Allow 2 to 3 weeks for delivery.