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Name:
_________________________________________________
Address:
_________________________________________________
Hamlet/Village/Town/City:
_________________________________________________
State/Province/Territory:
_________________________________________________
Country:
_________________________________________________
Postal/Zip
Code:
_________________________________________________
E-mail
Address:
_________________________________________________
Phone
Number (include Country and Area Codes):
________________________________________________
Fax
Number(include Country and Area Codes):
_________________________________________________
Dues |
Individual |
$60 (USD) for 1 year — $100 (USD) for 2 years |
Two
People |
$50 (USD)/each for 1 year |
Student*
18 and over |
$40 (USD) for 1 year |
Student**
18 and under |
$25 (USD) for 1 year |
Outside U.S. |
$65.00 (USD) for 1 year |
Lifetime |
$750 (USD) |
*Must be a full-time student, over 18. Please supply proof of student status.
**Must be a full-time student, under 18. Please supply proof of student status. This category will receive the electronic version of the SWW Sage newsletter. |
Method of Payment
- Check or Money Order (payable to SWW)
- VISA
- MasterCard
Card
# _______________________________ 3-Digit Security Code_____
Exp. Date ______________________________________________
Name on card ___________________________________________
Signature
_______________________________________________
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The SWW Newsletter is available on the website. |
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I wish to receive the SWW Newsletter by postal mail. |
| Dues |
$ |
Donation |
$ |
Total
Enclosed |
$ |
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