Member Information

Name(s):_______________________________________________________________

Address:_______________________________________________________________

City:____________________________State/Providence:________________________

Postal Code:_____________Country :________________Tel:____________________

Email:_______________________________________Fax:_______________________

Favorite Patterns: (3 max)_________________________________________________

 

Dues year is Jan 1 through Dec 31. FIRST TIME MEMBERS that join after Sept 1 will have their dues apply to the current and next years (2 for 1).  After Feb 15th, dues are delinquent and you will not be listed in membership roster.

 

 _____  check if you DO NOT WANT to be listed in membership roster.

Dealer Information

Business Name(s):_____________________________________________________________

Business Address:_____________________________________________________________

City: ______________________________State/Providence:___________________________

Postal code: ____________Country: ______________________Tel:_____________________

Email: ______________________________________________Fax:_____________________

Shop Hours:__________________(   ) Shows  - Specializing in:_________________________

Payment

Make Check payable to FBICC. (IN US FUNDS ONLY)

Dues: $45.00	$
Outside US: add $10.00	$
Dealer Section: add $10.00	$
Total Amount Enclosed	$

 

Please return to:         FBICC

Membership Chairman

PO Box 5427

Naperville, IL 60567-5427

USA

Flow Blue International Collectors’ Club

Membership Application