Membership Form

Our Membership/Subscription-year begins January 1. All memberships are for a calendar year from January 1 to December 31. We strongly encourage members to renew during the Fall months for the upcoming year. Please send your dues to

Poets and Patrons Treasurer
Beth Staas
1634 Barndsale Rd. #105
La Gramge, IL
60526
beth@staas.com

Membership Year
_____ 2016

Membership Status
_____ New
_____ Renewing

Regular Membership
_____ $20 United States

Contest Sponsorship
_____ $50 Sponsor

We are especially grateful to those who choose membership in special categories; It is difficult to meet our publication and mailing expenses on income from standard memberships only.

Payment method

_____ Check
_____ Money Order

______________________________________Name

__________________________________________________________________________________________________________Address


__________________________________________________________________________________________________________Email Address