ISAP Membership Registration and Payment

Name ______________________________________________________

Address 1 ___________________________________________________

Address 2 ___________________________________________________

City _______________________________________________________

State/Province _______________________________________________

Zip/Postal Code ______________ Country (if not USA) _________________

Day Phone __________________________________

Eve. Phone _________________________________

Cell Phone _________________________________

E-mail ______________________________________________

Website _____________________________________________

Would you like to (check all that apply):
____ Join a Regional Chapter?
____ Start a Regional Chapter?
____ Serve as a Board Member?
____ Serve on a Committee?

If you selected "Serve on a Committee," which one? Check all that apply:
____ Exhibitions
____ Publicity
____ Ways and Means
____ Catalogs
____ Sponsors
____ Newsletters

____ Check here if you do not want your name and address published for sponsor mailings.

Payment method: ____ Check enclosed ____ I'll use PayPal

Send completed form to:

Caroline Parrish
7 Del Rio Circle
Soquel, CA 95073