NOTE: This is a NEW form/format 2023 

One form will serve all three Life Membership requirements (CGCI, PRGC or NGC).  The electronic form will automatically go to the CGCI Chairman for tracking purposes, but the mailed copies will go to the individual chairman or address listed on the form.  

  • Life memberships may be purchased by individuals, organizations or districts to honor a member or individuals may purchase their own.
  • Complete the form at right.
    • Print TWO copies: one for your records and one to mail with check.
    • To reduce print size, go to print settings/scale and select “fit to printable area”
  • Send completed applications and checks to the address listed on the application form.

Life Memberships

Chairman: Linda Travis,
Honoring Our Members and Supporting the Scholarship Program

(This is a NEW FORM. PLEASE DO NOT use any of the old forms)
Note:  When certain options are selected i.e., “PRGC”, additional data fields will open.

List of Life Members 2024


Club Name
(Scroll down to select)
Name of club, district, or individual
Person submitting request
PRINT FORM (Print TWO copies, ONE to mail and ONE for your file, before clicking on Submit)