Please type or print and send, along with a check payable to Zane Grey's West Society, to this address:

ZGWS, Therese Pleau/Irene Chasse, P.O. Box 877, Sabattus, ME 04280

 
   
  Date: ___ /___ /___          
               
  First Name: _____________________ Middle Name: __________________  
               
  Last Name: ___________________________      
   
  Street Address (Number & Street): ____________________________________  
               
  City: ___________________________ State: ______ Zip Code: __________  
               
  Telephone: ( ___ ) _________________ E-mail: __________________________  
   
  Membership Category:          
               
  Regular Active Member - $35
($45 for International)		      
               
  Student Member - $15
($25 for International)

    I desire additional information on
   purchasing back issues of Society
   publications.		  
   
  I learned about Zane Grey's West Society from:

A friend or acquaintance
The Zane Grey's West Society website:
www.zgws.org
Other:  Please specify:
 
   
  May we include your address, phone number, and e-mail address on our membership list?
(Note: List is distributed to Society members only.)		   Address:

Tel. Num.:

E-mail: 		    Yes                No

    Yes                No

    Yes                No