IILG
Membership Application

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Send payment via PayPal or Check or Money Order


Date
Email Address     Yahoo! ID/Profile
Name (First MI Last):
Address
City ST   Zip Code
Country
Phone        Spouse's Name
Occupation
Other Leather Guild Membership(s):
     
How I heard about IILG:
     
I've been doing leatherwork since (year)
Type(s) of leatherwork I enjoy
Currently, I work with leather as HobbyBusinessBoth
Business Name
Website URL (if any)
I would like to purchase:
additional Patch(es) at $5 per patch
additional Pin(s) at $3 per pin
Payment Method for Dues (plus added items, if any) PayPalMoney OrderCheck
Remarks: