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.

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

Remarks:												
													
Dues [annual] $10
Initiation Fee [one-time] $10
Extra Embroidered Patch[es] $5 for each additional
Extra Pin[s] $3 for each additional

[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
	treasurer@iilg.net