Membership Renewal Members are asked to make an annual donation based on the following recommended amounts. However, the most important thing is that you join us, so there is no minimum amount for membership. Please contribute what you can reasonably afford. Membership * Student/Youth - $ 25.00 Individual - $ 50.00 Family - $ 75.00 Neighborhood Organizer - $ 150.00 Campaign Convener - $ 250.00 Movement Funder - $ 500.00 Pay-What-You-Can - $ 1.00 Please renew my membership automatically. Membership will renew automatically. Donation Amount Total Amount Your Information First Name * Last Name * Email Address * Phone Postal Code * Age Race/Ethnicity - none - Latino African-American Asian White/Caucasian Arab-American Indian-American Other Unknown Gender / Preferred Pronoun Participant Role - select - Attendee Volunteer Host Speaker Participant Note Indicate whether participant is a student, community service partner, or potential community service partner Payment Options Payment Method Credit/Debit PayPal Credit Card Information Card Type - select - Visa MasterCard Amex Discover Card Number * Security Code * Expiration Date * -month- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec -year- 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 My billing address is the same as above Billing Name and Address Billing First Name * Billing Middle Name Billing Last Name * Street Address * City * Country * - select - United States State/Province * - none - Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Postal Code * As a renewing member of the Mid-South Peace and Justice Center I will continue my work to support and uphold the mission to engage, organize and mobilize our communities to realize social justice through nonviolent action.