Wait List Application

"*" indicates required fields

Billing Contact Name*

Enter the name of the person who should be contacted if membership becomes available or with any questions regarding the wait list application.

First Last

Address*

Street Address City State ZIP Code

Primary Phone*

Alternate Phone

Work Phone

Email*

This will also be your username.

Password*

Select a password that you will use to access your wait list account. You will be able to send a password reset link to the email address you entered above if necessary.

Enter Password Confirm Password

Strength indicator

Membership Category Requested*

Choices are: Multigenerational, Large Family (5+), Small Family (3-4), Couple, Single, Senior Couple (both 60+), Senior Single (60+). Detailed member category descriptions may be found on our website: www.planetgranite.org/membership-categories.html

Signature*

Application Fee (non-refundable)

Price:

Payment Method*

Credit Card

ACH Payment

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

ACH*

Account Number Account Type Routing Number Account Holder Name

CAPTCHA

Order Token