Arizona State Poetry Society

Membership Form:    

Calendar year dues are $15.00 and are payable to the Arizona State Poetry Society. Chapter dues are an additional $5.00 for each chapter you wish to join (check at the bottom of the form). Be sure to look in the Calendar for the scheduled meeting times and locations. See you there!

Note: If you don't have printer access, simply copy our Treasurer's address below and send a check with the appropriate amount.

Print this page first then fill it in and send this completed form and your check to: 

Christy White , ASPS Treasurer, 5126 East Mark Lane
Cave Creek, AZ 85331

 Name:__________________________________________________

 

Address:_________________________________________________

 

City, State, Zip:_________________________________________

 

Telephone, Fax, Email:____________________________________

 

 ________________________________________________________

 

  Patron: $________(optional) Minimum $10.00 donation

 

 Check if you are interested in one or more of these local branches

  send additional $5.00 dollars for each branch you wish to belong to:

 

 ___Douglas  ___Glendale   ___Northern Arizona  ___Phoenix  ___Scottsdale 
___Sun Cities   ___East Valley  ___Tucson

 

Total of the Membership Dues enclosed: $________