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 Contributing Membership one year: Includes voting rights and
membership card
______$20 Sponsors Membership one year: Includes everything in a
Contributers + More
$5 off to those with Studant IDs(include copy), $5 off for family members
residing at the same address not comunitalive unless buying Sponsors membership)
Total enclosed: $ _______
If this is a family membership, send ALL applications in same envelope
with ONE check or money order. 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
319 Yerger Drive
Bozeman, Montana 59718
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
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Application received: ____________ Local Chapter:
_________________________________
Waiver received: Yes ____ No ____ Membership Class:
_______________________________________
Membership Number: _____________ Next fees due: ______________