INTERNATIONAL INTERNET LEATHERCRAFTERS' GUILD, INC

~ MEMBERSHIP APPLICATION ~

Date:

Email Address: Yahoo! ID/Profile:

First Name: M.I.: Last Name:

Address:

City: State: Zip: Country:

Phone No.: Spouse's Name:

Occupation:

Other Leather Guild Membership(s):

How I heard about the Guild:

I have been working with leather since the year:

The type of leatherwork I enjoy doing:

Currently, I work with leather as a: Business Hobby Both

Business Name:

Website URL (if any):

I would like to order additional IILG Embroidered Patch(es) at $5 per patch

and/or additional IILG Lapel Pin(s) at $3 per pin.

Remarks:

Dues [annual] $10

Initiation Fee [one-time] $10

Extra Embroidered Patch[es] $5 for each additional

Extra Pin[s] $3 for each additional

Payment Method for Dues (plus added items, if any) __PayPal __Money Order __Check

[if paying by check/money order make payable to: "International Internet Leathercrafters Guild"]

[US funds only]

Return to:

Pat Hay

IILG Treasurer

PO Box 98

Cary, Mississippi 39054