Georgia Life Membership Brothers, you’re invited to join the State of Georgia Organization’s Life Membership program. Life Membership Application Form The Georgia State Life Membership cost is $375. There are no installment plans for this membership and a single payment must be submitted along with a completed application to be considered for Georgia State Life Membership (GSLM). Furthermore, maintaining current International, District and Chapter dues is required for Georgia State Life Membership. Registration FormBrother Name* First Middle Last Suffix Current Chapter*Initiation Chapter*Chapter Location*Initiation Date*Control Number*International Life Membership #*Email* Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Evening Phone*
