NEW MEMBER FORM - 2012

Welcome! You may pay dues through your Circle or Branch, or is you are not affiliated with either of those, you may send your 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__________________

Checks should be made payable to IOKDS.

Credit Card Information: VISA______Mastercard_____ Expiration Date__________

Credit Card #___________________________________________________________

Signed________________________________________________________________