____ New Member ___ Renewing Member _____ Address Change
Your name: __________________________ Spouse's name ____________________
U.S. mailing address: street and apt. # or P.O. Box ______________________________
City, state, and zip code _____________________________________
Telephone # __________________ optional e-mail address _________________________
Years of service at which qualifying company(s)? _____________________________
Annual Membership Fees - $5.00 for one year or $12 for three years.
Make your check payable to the 'VIP Club' then mail to:
VIP Club P.O. Box 131748 Roseville, MN 55113-0020
We distribute a directory about every other year to VIP Club members only - If you do not wish to have your name listed therein, check here. ____ Only 1.5% of the membership have elected this option.
Your subscription to our monthly newsletter will begin the month after we receive the membership application.
Thanks to Joe Schwarz for the membership form layout.