Print the following membership application using your browser's "print"button.  After printing this page use your browser's "Back" button to return to the FBICC website.  Mail the completed form to:

 

Flow Blue International Collector's Club, Inc.

c/o Jim Swan, Membership Chairman

P.O. Box 442464

Lawrence, KS 66044

Please enroll/renew me as a club member of the Flow Blue International Collector's Club, Inc.

Members Name(s):____________________________________________________________

Address:_____________________________________________________________

City/State/Zip:________________________________________________________

Phone: _______________________        FAX:______________________

E-Mail:_______________________________________________________________

Favorite Patterns (Limit 3)

____________________________________________________________________

New Member: _____                                   Renewal: _____

____ Please check if you do NOT want  your name and address listed in the club roster.

Date:_______________          Year Paying For: 200__

(Dues year: January 1 through December 31; dues are delinquent after January 15; members enrolling/renewing after January 15 will NOT be listed in Club Roster.)

DUES:                                   $39.00

Outside U.S.:                add $10.00

    TOTAL:                      ________ 

Dues include up to two people same address

U.S. CURRENCY ONLY