Return to Membership Page

JOIN THE AIS YOUTH

USE THIS FORM TO JOIN
(Fill out & Print this page.  Mail the completed page with your dues)
You may either print this as a blanck page and fill it out by hand,
or fill it out now, then print the completed page.
THIS PAGE DOES NOT SUBMIT ANY INFORMATION VIA INTERNET.
IT IS FOR YOUR CONVENIENCE ONLY.

Name:     

Address: 

City:         

State:             Zip: 

Phone:    

E-mail:    

Birthdate of Youth     

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

Single Annual  Without Bulletin  $8.00    
          
Single Annual  With Bulletin     $12.00  

New Membership                   Renewal Membershp  

For more Membership Rates and Dues, contact Pam Messer.

 
  Mail CHECK and FORM To:

Pam Messer
AIS Membership Secretary
PO Box 6
Huxley, IA 50124