Please print out and complete this form and mail it to the Society.
Membership and Subscription Form
THE DEAN BURGON NEWS
Published As the Lord Supplies By The Dean Burgon Society, D.
A. Waite, Editor,
Box 354 - Collingswood, NJ 08108
Editorial Committee: M.J.Hollowood & D. A. Waite
SEND GIFT SUBSCRIPTIONS:
All gifts
to Dean Burgon Society are tax deductible!
THE DEAN BURGON SOCIETY
Box 354 - Collingswood, New Jersey 08108, U.S.A.
Phone: (856) 854-4452
MEMBERSHIP FORM
I have a copy of the "Articles of Faith,
Operation, and Organization" of The Dean Burgon Society, Incorporated. After
reading these "Articles," I wish to state, by my signature below, that I believe
in and accept such "Articles." I understand that my "Membership" is
for one year and that I must renew my "Membership" at that time in order to
remain a "Member" in good standing of the Society.
[ ] I wish to become a member of
The Dean Burgon Society for the first time.
[ ] I wish to renew my membership subscription which has expired as of:
___________
SIGNED:____________________________
DATE:______________________________
I enclose: (Attention: The Dean Burgon Society Box 354 -
Collingswood, New Jersey 08108)
*Membership Donation ($15.00/year) $__________
*Life Membership Donation ($100.00) $__________
*Student Membership Donation ($7.00/year) $__________
*Additional Donation To The Society $__________
TOTAL:
$__________
Please PRINT in CAPITAL LETTERS your name and address below:
NAME:__________________________________________
ADDRESS:______________________________________
CITY:___________________________________________
STATE:________________________ ZIP:_____________ E-mail Address:__________________________________
Phone Number:__________________________________
[ ]
Although I am not a member of The
Dean Burgon Society, I do wish to subscribe to the Newsletter, by making a gift of
$10.00 to the Society.
NAME:__________________________________________
ADDRESS:______________________________________
CITY:___________________________________________
STATE:________________________ ZIP:_____________
E-mail Address:__________________________________
Phone Number:__________________________________
I understand that, included in my first $10.00 gift accompanying any
donation or order regardless of the amount of the order or donation is my year's
subscription to The Dean Burgon Society NEWS-LETTER. (
Canada
& All Foreign Subscriptions $12.00 Yearly)
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