Member’s Profile Form

Please fill out the requested information and send the form to
ISCS, PO Box 1786, Lilburn, GA 30048 USA.

Dues are complimentary for new members for the first year. After the first year the dues are $12 for US and $15 for non-US members (US currency only).

Last Name:__________________________________________________________
 
First Name:__________________________________________________________
 
Address:____________________________________________________________
 
____________________________________________________________________
 
City:________________________________________________________________
 
State/Province: _______________ Postal Code: ________________
 
Country_______________________________________________________________
Preferred Contact Phone#________________________________________________
 
E-Mail Address:_________________________________________________________
 
Mailing Preference: E-Mail _____________ Regular Mail ______________
 
Trade Sand: Yes _____________ No _____________
 
Additional Info (special interest, additional phone/FAX #’s, etc):
____________________________________________________________________
 
____________________________________________________________________
 
____________________________________________________________________