Fagowee Membership Form


Directions:  Please print this form, circle the appropriate choice of membership, and mail with check to:
  Fagowees International
Washington Branch
P.O. Box 470
Temple Hills, MD 20757
Name:  ________________________________________________
Nickname:  ________________________________________________
Address:  ________________________________________________
City:  ________________________________________________
State:  ________________________________________________
Zip:  ________________________________________________
Home Ph #:  ________________________________________________
Work Ph #:  ________________________________________________
Date of Birth:  (month/day) ________________________________________________
Email:  ________________________________________________
New Members: 

 How do you want your name to appear on your pin?

 

New Members *
Individual

$25

Family

$30

Lifetime *
Individual

$200

Family

$300

Renewal *
Individual $20
Family $25

(*Includes membership pin)