​Carlos Museum Membership Form

​Carlos Museum Membership
Please complete the following information. Required fields are marked with an asterisk (*). If you are a teacher, Emory faculty, staff, alumni, or student interested in a discount, you may join by mail, onsite, or by calling our Membership Office at 404.727.2623. The discount is not currently available online.

Membership Information
New or Renew Membership


Membership Levelsrequired
Term Auto Renewal Price
Active through 8/31/2018 $50.00

Active through 8/31/2018 $75.00

Active through 8/31/2018 $100.00

Active through 8/31/2018 $140.00

Active through 8/31/2018 $150.00

Active through 8/31/2018 $300.00

Active through 8/31/2018 $600.00

Active through 8/31/2018 $1,500.00

Active through 8/31/2018 $5,000.00

Active through 8/31/2018 $10,000.00


If you are a new member, your expiration date will be on or after the term date listed above. If you are a renewing member, your expiration date will be extended one year from its current date.
I want to make an additional contribution:
Additional Contribution:
$
This contribution will provide annual support for Carlos Museum exhibitions and educational programs.
Promotion Code
Are you using a corporate card for this gift? (Check for YES):
If so, please provide company name:

 

Enter any additional comments here:
Gift Membership Information


If you are purchasing this membership as a gift, please include the name and contact information of the person(s) receiving the membership in the fields below. Please note that without complete address information, we are unable to send a membership notification to the recipient(s).

First Adult Information

Prefix:
First Name:
Last Name:
Suffix:
Email Address:

Notification Information
Phone Number:
Phone Type:
Address 1:
Address 2:
City:
State:
Zip:

Second Adult Information

Prefix:
First Name:
Last Name:
Suffix:
Email Address:

Your Information
Title (Mr., Mrs., etc.):
First Name:
required
Middle Name:
Last Name:
required
Suffix (Jr., Sr., etc.):
Email Address:
required
Emory Class Year:
Date of Birth:
RadDatePicker
RadDatePicker
Open the calendar popup.
Please enter your phone number in the following format: xxx-xxx-xxxx.
Primary Phone Number:
Primary Phone Type:
Home Address Street 1:
required
Home Address Street 2:
City:
required
State/Province:
required
Country:
Zip/Postal Code:
required

Second Adult Information

Secondary Phone Number:
Secondary Phone Type:
Second Adult First Name:
Second Adult Last Name:
Second Adult Middle Name:
Second Adult Relationship:
Second Adult Email Address:
Employer Information
Employer Name:
Check here if your employer has a gift matching program: