New Member Application

International Phalaenopsis Alliance
New Member 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
We Do Not Invoice for new member fees

The IPA does not charge for shipping AND we do accept and or

Applicant Information: . . . Directions ... Please type in this form on your computer screen, then go to confirmation page and 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 Your Membership:

Questionnaire: . . . Please select from the below which best describes your current orchid growing status

Select Payment Method: . . . Payable in US Dollars

Check Number Total: $
Applicant Information: . . . Directions ... Please type in this form on your computer screen, then go to confirmation page (NEXT) and verify that all the information is correct (if applicable, type in Credit Card Information), then print out, sign, and mail.

Problems Submitting?

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