MEMBER-AT-LARGE DUES FORM - 2012

 

 

Current and prospective members who do not belong to a Circle or Branch may pay dues directly to The King's Daughters and Sons and enjoy the rights and privileges of all members, including a subscription to The Silver Cross magazine.  Just fill out the form below and mail it with your check payable to IOKDS or credit card information to:  IOKDS, P. O. Box 1017, Chautauqua, NY 14722-1017.

 

 

Name______________________________________Telephone__________________

 

Address_______________________________________________________________

 

______________________________________________________________________

 

Zip code______________E-mail address_____________________________________

 

Former Branch, if any______________Former Circle, if any______________________

 

 

Payment is being made for:

 

 

International Dues, $25.00_______

 

or

 

International Dues and Chautauqua Chapter Dues $27.00_______

 

 

Donation_______________

 

 

Total__________________

 

 

 

Credit Card Information:  VISA______Mastercard_____   Expiration Date__________

 

Credit Card #___________________________________________________________

 

Signed________________________________________________________________