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Print and then mail the form below to:
IREA c/o Sonia Vogl, Treasurer
1230 E. Honey Creek Road.
Oregon, IL 61061 any questions call Sonia at (815) 732-7332

Name_________________________________________________________

Business or Organization___________________________________________

Address_______________________________________________________

City______________________ State______Zip___________  

Phone____________________________  Fax_________________________

Email address_____________________________________________

Web site address_____________________________________

Membership Category (check one)

c $10 - Student
c $20 - Individual
c $35 - Family
c $$100 - Organization/Business

Make your check payable to "IREA" — Additional donations welcome.

This is what I can also contribute to IREA:

* VOLUNTEER TIME (please list what you would like to do)
    _______________________________________________
    _______________________________________________
    _______________________________________________
    _______________________________________________

* CONTRIBUTIONS OF
   -money $__________
   -equipment or services _____________________________
    _______________________________________________

* SPECIAL TALENTS (please list)
   ________________________________________________
   ________________________________________________
   ________________________________________________