| Quantity | Each | Total | ||||
| Membership type(s): | Individual | _______ | $ 20 | _______ | ||
| Associate | _______ | 5 | _______ | |||
| Child (under 12) | _______ | Free | ||||
| Total Amount: | _______ | |||||
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Full individual membership includes a subscription to Butterfly Net, the official newsletter of FAGCA, as well as full voting rights. Memberships are renewed on a calendar-year basis. Associate memberships are for additional members within the same household. Memberships for children under age 12 are free. Please list associate/child member names below. (Please list birthdates for members under 18.) _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ Please mail this form, as well as a check or money order to: Fenton Art Glass Collectors of America, Inc. P.O. Box 384 Williamstown, WV 26187 | ||||||