Membership Application for the Outremer Society

(ONE application per person)

All sections must be completed:

Date of application: ____________________

Legal name: __________________________________________________

Mailing Address:

|______________________________________

|______________________________________

|______________________________________

Telephone number (including area code): _____________________ Best time to call?_______________

Email address: __________________________________________

How did you hear about The Outremer Society? ____________________________________________________________________________

Membership Fees: check appropriate line

______FREE Basic Membership one year: Non-voting member

______$10 (Jan-June) or $5 (July-Dec) Contributing Membership one year: Includes voting rights and membership card.  May use the title of Lord

______$20 (Jan-June) or $10 (July-Dec) Sponsors Membership one year: Includes everything in a Contributers + also the right to make propossal's to the Society and run for Baron

______$30 (Jan-June) or $15 (July-Dec) Patrons Membership one year: Includes everything in a sponsors + Right to run for Count

______$40 (Jan-June) or $20 (July-Dec) Royal Membership one year: Includes everything in a sponsors + Right to run for Duke or Monarch

$5 off to those with Student IDs (include copy) before July, $2 off afterwards Family discounts are not needed as Free memberships are offered. Free memberships have no voting rights

Free Members must also sign waivers to participate.

Total enclosed: $ _______

PLEASE keep a copy of all paperwork for your records. Waiver(s) MUST be included with application(s) or it/they will not be processed.

Forms of payment accepted: (made payable to: “The Outremer Society”)

Personal check

Money order

Do NOT send cash!

Mail to: The Outremer Society

Register: Ally Scheiner

239 Golden Trout Way

Bozeman, Montana 59715

USA

Please allow 2 to 4 weeks for processing of your application. You will receive a membership card and certificate in the mail if applicable.

Do NOT write below this line

Application received: ____________ Local Chapter: _________________________________

Waiver received: Yes ____ No ____ Membership Class: _______________________________________

Membership Number: _____________ Next fees due: ______________