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Name___________________________________________
Address_________________________________________
City_________________ State (Province)_______________
Zip (Postal Code)________ Country____________________
Phone Number (With Area Code)______________________
e-mail address____________________________________
Specific Interest in Flags_____________________________
________________________________________________

I wish to join Great Waters Association of Vexillology as:
   [ ]An ACTIVE member (resident of IL, IN, KY, MI, OH) Dues: $10.00
   [ ]An ASSOCIATE member (outside the 5 state region) Dues: $5.00   
   [ ]An ASSOCIATE member (outside North America) Dues $10.00

Dues are for current calendar year the dues are received. 

Print out this application and mail with your check or money order (payable in U.S. funds) to Peter J. Kinderman at:

        3075 Madison Road
        Cincinnati, Ohio 45209
        U.S.A.

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