Join | Krewe of Black & Gold

Payor's Name *

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Last

Payor's Email *

Phone (will only be used if there is a problem processing membership)

Mailing address to which donor gifts should be sent *

Address Line 1

Address Line 2

City

State

Zip Code

If you are making a donation only without gifts to be shipped, please mark all address fields n/a.

Please indicate if this includes gift(s)

Gifted membership/donation(s)

MEMBERSHIP OPTIONS

For multiple submissions on a single form, all member gifts will be mailed to the mailing address indicated above. If multiple shipping options are desired, a separate form should be submitted for each shipping address desired. To add member(s) names and optional dedication(s) to the online Spirit of Louisiana pages, please add that information where indicated below. Maximum of four Founding Members and four VIP Founding Members per form. Please complete this information prior to submitting payment.

Krewe of Black & Gold Founding Memberships

One membership - $25.00
Two memberships - $50.00
Three memberships - $75.00
Four memberships - $100.00

Krewe of Black & Gold VIP Founding Memberships

One VIP membership - $50.00
Two VIP memberships - $100.00
Three VIP memberships - $150.00
Four VIP memberships - $200.00

Other (donation to support event without membership - please indicate donation amount)

If you wish to support this event without a membership, your donation is greatly appreciated. Please indicate amount of donation.

Minimum Price: $10.00

SPONSORSHIP OPPORTUNITIES

If you would like to receive information about the Spirit of Louisiana Jazz Funeral and Second Line sponsorship opportunities, please provide contact name and email address as indicated. Sponsorship levels begin at $500.

Potential sponsor contact name

Potential sponsor email address

MEMBER NAMES AND DEDICATIONS

For gifted submissions, you are verifying that you are authorized to include your recipients' names and/or dedications in the online directory. To allow your gift recipients to complete their own member directory and/or dedication listings, please list donor's name from line one of this form and "TBD" in appropriate fields. Instructions for their personalizations will be included on the gift certificates available following checkout.

MEMBER NAMES: Please list member names exactly as desired to be listed in the online member directory. If no online listing is desired please mark the spaces "N/A." Maximum 40 characters.

DEDICATIONS: Please mark spaces "N/A" if no dedication is desired. Dedications should indicate whether "In memory of" or "In honor of" and from whom the dedication is presented, i.e. "In loving memory of John Smith from Jane Smith" or "In honor of General Hospital ICU Staff from the Smith family." 100 character max.

FOUNDING MEMBERS

First Founding Member's Name *

First

Last

First dedication and signature name

Second Founding Member's Name *

First

Last

Second dedication and signature name

Third Founding Member's Name *

First

Last

Third dedication and signature name

Fourth Founding Member's Name *

First

Last

Fourth dedication and signature name

VIP FOUNDING MEMBERS

First VIP Founding Member's Name *

First

Last

First VIP dedication and signature name

Second VIP Founding Member's Name *

First

Last

Second VIP dedication and signature name

Third VIP Founding Member's Name *

First

Last

Third VIP dedication and signature name

Fourth VIP Founding Member's Name *

First

Last

Fourth VIP dedication and signature name

PAYMENT SUBMISSION

Total *

$0.00

Please review your selections and total, and complete members' information and dedications prior to submitting payment. Clicking the SUBMIT link will open the payment window on PayPal's secure payment website for payment submission via PayPal or credit card. If the PayPal link does not activate, please review your form to ensure all required fields have been completed.

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Click the PayPal link to pay via PayPal or credit card.

Join the Krewe

MEMBERSHIP OPTIONS

SPONSORSHIP OPPORTUNITIES

MEMBER NAMES AND DEDICATIONS

FOUNDING MEMBERS

VIP FOUNDING MEMBERS

PAYMENT SUBMISSION