IPA Membership Form

To join as a new member or to renew your membership for year ending Oct. 1, 2007

Instructions:

Print out the blank membership form on this page. Fill it out in pen, then mail it with a check made out to:

Iowa Poetry Association

Regular dues - $8.00
Patron dues - $15.00

Current members should check their latest newsletter mailing label to see if current dues are paid. If not, please catch up by remitting for both years together.

Mail to:

Iowa Poetry Association
Lucille Morgan Wilson
2325 61st Street
Des Moines, IA 50322

Please check one:       New Member        Renewal    

Name: ______________________________________________________

Address: ____________________________________________________

City, State, Zip: _______________________________________________

Telephone: (Home)___________________ (Work)___________________

E-Mail Address: _______________________________________________

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