Please Print this Application & Bring it with You to our Next Meeting!

Three Rivers Depression Era Glass Society

2008 Membership Application

Name ____________________________________________________

Address __________________________________________________

City, State, Zip Code ________________________________________

Phone # __________________________________________________

E-Mail Address _____________________________________________

Shop Name (if you are a Dealer) _______________________________

Patterns/Items of Special Interest that you collect:

__________________________________________________________

__________________________________________________________

Signature __________________________________________________

Adult Membership Dues are $15 for Single or $22.50 for Family (2 people)

Junior Membership Dues are $7.50 (18 years and under)

Make checks payable to the Three Rivers Depression Era Glass Society