Online Membership Form

Step 1: Fill out all fields in our online membership form and press submit.

Step 2: Click on the appropriate membership choice

StepĀ 3: Add item to cart

Step 4: Complete your purchase, process payment.

 

If you do not follow through with all required steps, your membership will not be processed.

Yes! We want to join The Garden State Discovery Museum!

* denotes a required field

*Membership Categories

Please fill in both adult's first and last names as you wish them to appear on your membership card.

Adult 1

*First Name

*Last Name

Adult 2

*First Name

*Last Name


Contact Information

*Address

*City

*State

*Zip

*Daytime Phone

Evening Phone

*Email


Names and dates of birth of children

*Child 1
*Name:

*Date of Birth: / /

Child 2
Name:

Date of Birth: / /

Child 3
Name:

Date of Birth: / /

Child 4
Name:

Date of Birth: / /

Child 5
Name:

Date of Birth: / /


Gift Membership - Gift Giver Information:

Name

Address

City

State

Zip

Daytime Phone

Evening Phone

Email