Join Form

JOIN THE REBLOOMING IRIS SOCIETY

  

USE THIS FORM TO JOIN

  

THIS PAGE DOES NOT SUBMIT
ANY INFORMATION VIA INTERNET.
IT IS FOR YOUR CONVENIENCE ONLY

  

Name:     

Address: 

City:         

State:           Zip: (Plus 4) 

Phone:    

E-mail:    

Membership Dues (Please CHECK "X" appropriate box.)

Single                                                 Dual
Annual         $12.00                    Annual          $15.00   

Single                                                 Dual
Triennial       $30.00                   Triennial       $40.00   

Overseas members please add $5.00 to each year of the
domestic rates show AND Check "X" mark this box:                           
  
AIS Member?  (Please Check)        YES                 NO

New Membership        -- or --   Renewal Membership  
 
Mail CHECK and FORM to:

Rose Kinnard
1649 Madison 504
Fredericktown, MO 63645-8303