Please print this page and mail it to us at the address below.
Name:__________________________________________________________
Company:_______________________________________________________
Position:______________________________________________________
Street Address:________________________________________________
PO Box:________________________________________________________
City:__________________________________________________________
State:_______________________________ Zip:_____________________
Phone:___________________________ Fax:_________________________
Email Address:_________________________________________________
Proposed By:___________________________________________________
Spouse's name:_________________________________________________
Birthday Date:_________________________________________________
Anniversary Date:______________________________________________
Annual Dues: $50.00 (enclosed)
I wish to make a donation of __________________ (enclosed)
Thank You!
Send to:
The Intimate Apparel Square Club
326 Field Road
Clinton Corners, NY 12514
