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MEMBERSHIP FORM
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NAME(s):
ADDRESS:
CITY, STATE, ZIP:
AREA & TELEPHONE:
EMAIL ADDRESS:
DATE:
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2008 MEMBERSHIP DUES:
$25.00 Single member
$13.00 ea. add'l members
(at same address)
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Please copy this form, make your check or money order payable and mail to:
20-30-40 Glass Society of Illinois, Inc.
P O Box 856
La Grange, IL. 60525
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What do you collect? Please tell us about your collection here:
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Are you interested in presenting a display of your collection to our members? ____ Do you have a special topic that would make an interesting program for the Society? __________ Please add your talents to the Club.
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