Gift Membership Application . . .

Note:  As a non-profit organization we must make all attempts to keep mailing cost to a minimum.   Please mail your new membership application along with the appropriate remittance to the address as shown on following confirmation page.  This form is for mail application by Credit Card or Check only

We Do Not Invoice for new member fees

Applicant Information: . . . Directions ... Please complete this form, press next to  go to  confirmation page to verify that all the information is correct (if applicable, type in Credit Card Information), then print out, sign, and mail. 

First Name:  
Last Name:  
Company:  
Address:  
City:   State/
Province:		   Postal/
Zip Code:		   Country
Home Phone:   Work Phone:
FAX: Email:
 

Select the Gift Membership:
 

Subscribe to the Phal Digest ,  . . . Member benefit . . . No Charge


YES   NO

One Year Membership . . .  US and Canada US$    36.00            
Two Year Membership . . .  US and Canada US$    70.00             
One Year Membership . . .  Overseas US$    60.00             
Two Year Membership . . .  Overseas US$  115.00            
Associate Membership . . .  US, Canada and Overseas
Only one Associate Member may be added to any  membership in same household. They will receive all the benefits as a full Member except they will not receive a copy of Phalaenopsis

US$      5.00           
*Only  at time of primary registrants    enrollment ... not available separately 

The color images in the IPA journal, 'Phalaenopsis' are funded by donations from the membership...  Please consider a contribution with your Gift  Membership to help support this popular part of the IPA  journals efforts to continue providing quality color in its issues.

 $ 10.00   $   25.00 
$  50.00   $ 100.00 
 
Questionnaire: . . . Please select from the below which best describes the current orchid growing status of the recipient

They grow in/on a . . .   They are a . . .  grower   They grow for a  . . .  
Greenhouse Beginner Hobby
Windowsill Intermediate Commercial Grower
Under Lights Advanced    
 

Gift Givers Information:
 
First Name:  
Last Name:  
Company:
Address:  
City:     State/Province:    Postal/
Zip Code:		   Country
Home Phone:   Work Phone:
FAX: Email:  

Select Payment Method: . . . Payable in US Dollars 
 

             Check Number     Total:  $     

Applicant Information: . . . Directions ... Please complete this form, press next to  go to  confirmation page to verify that all the information is correct (if applicable, type in Credit Card Information), then print out, sign, and mail.  This form is for mail application by Credit Card or Check only.                                               

Problems Submitting?

             All rights reserved.  Revised: 07 Apr 2010 18:57:13 -0400   Copyright © 1999 by International Phalaenopsis Alliance.