| Date
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| Email Address
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Yahoo! ID/Profile
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| Name (First MI Last):
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| Address
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| City
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ST
Zip Code
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| Country
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| Phone
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| Spouse's Name
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| Occupation
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Other Leather Guild Membership(s):
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How I heard about IILG:
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| I've been doing leatherwork since (year)
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| Type(s) of leatherwork I enjoy
|
| Currently, I work with leather as
HobbyBusinessBoth |
| Business Name
|
| Website URL (if any)
|
| I would like to purchase:
additional Patch(es) at $5 per patch
|
|
additional Badge(s) at $5 per badge
|
|
additional Pin(s) at $3 per pin
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| Payment Method for Dues (plus added items, if any)
PayPalMoney OrderCheck |
Remarks:
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