Membership Application
AMERICAN GOURD SOCIETY, INC
P.O. Box 2186
KOKOMO, INDIANA 46904-2186
New____     Renewal____     Date___________

Please Print:

NAME _________________________________________________________________

STREET ________________________________________________________________

CITY ___________________________________________________________________

COUNTY________________________________________________________________

STATE __________________ ZIP ________________COUNTRY___________________

Email:__________________________________________________________

***SNOWBIRDS -- more than one address??? -- please read

PHONE (________) _________ - ________________

  Your membership information will only be used for official AGS business.
 
 

Dues ( U. S.): $15.00 one year;         $30.00 two years;         $40.00 three years
Dues (Outside U. S.):  $22.00 one year;         $44.00 two years;         $60.00 three years
Dues for the AGS are $15 per year, no matter when you join. Your membership will expire the following January. We will mail you back issues of The Gourd for the year in which you joined.

IF YOU JOIN IN NOVEMBER OR DECEMBER, YOUR MEMBERSHIP WILL START NEXT JANUARY.

Mail Dues to above address