Manx Society of Minnesota

Membership Form

Please print this form and mail check/money order to:

Joan L. Gill, Treasurer

10215 - 38th Court North

Plymouth, MN  55441-1669

Name: ____________________________________________________

Address: _____________________________________________City______________State_____Zip___________

Phone: _______________________________________

E-mail: __________________________________________

Enclosed:

$____________membership dues - $7.50 annually

$____________as a tax deductible donation to the Manx Society of Minnesota

        ______ Yes, I would like to receive the newsletter by electronic mail.

                        My e-mail address is: _____________________________________

A membership card will be sent upon receipt of your dues and a contribution letter upon receipt of your donation.

New Members:  Please give a brief summary of your connections to the Isle of Man on the back of this form.

For  additional information contact:  Joan Gill, Treasurer