Your Mailing
address:
First Name |
Last Name |
|
Address |
||
Address |
||
City |
State/Cntry |
Zip/Postal Code |
E-Mail | Telephone | |
Memb. status: (circle one) Member Non-Member |
Membership number:
(optional) |
Your Subscription:
Duration: (circle one) One Year ($40 US, $55 non-US) Two years ($75 US only) |
Membership:
Care to join now? Just select a membership type: (circle one) | ||
$35: Regular | $100: Supporting | $500: Benefactor |
$20: Student/Lim. Income | $2500: Lifetime | $10,000: Angel |
Your Payment:
Please make all checks payable to IFGE.
Payment Method: (circle one) Check Money Order Charge |
||
Credit Card Number: |
||
Exp. Date: |
Type: (circle one) Visa Mastercard |
|
Name as it appears on your card: |
||
Signature: |
||
|
Subscription Amount: |
|
Membership Amount: |
||
Total Amount: |
Send payment to:
Thank you for your subscription. |