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PRINT OUT APPLICATION

Check where appropriate:

• This is a Gift Membership FROM: ________________________________________________
• Individual, U.S. -- $20
• Family, U.S. -- $35
• Canada, Individual -- $25
• International, Individual -- $30
• Individual, Junior -- $10 (Age 18 or Less during the current calandar year)
• Life Membership -- For a Donation of $1000 or more, the Company of Fifers & Drummers will establish a Life Membership in the name of the Donor. (Only ONE donor name per Life Membership please!)
• I would like to learn about flexible payment schedules for a $1,000 donation.
• Corps Discounts -- I would like to learn about big savings for 10 or more individual memberships.

Name _______________________________________________________

Address _________________________________________________________

City_____________________________________________________________

State__________ Zip ____________ Tel. ( _______) ______________________

E-mail________________________ Website_____________________________

Corps affiliation_____________________________________________________

Fife   Snare Drum   Bass Drum   Drum Major   Color Guard
Other:_____________________

If this application is for a Junior Membership, please list age: ________

The Company of Fifers & Drummers, Inc.
P.O. Box 277
Ivoryton, CT 06442-0277 USA

Thanks
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