
Back to main membership page | Home
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.
Everyone can contribute something!
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)
________________________________________________
________________________________________________
________________________________________________ |