Membership Join

The Genuine Indian Relic Society, Inc. Membership Form

Please provide the following contact information:

Name

Street Address

Address (cont.)

City

State/Province

Zip/Postal code

Country

Telephone

E-mail

URL

Member Options

Payment:

Gift Membership

Name

Street Address

Address (cont.)

City

State/Province

Zip/Postal code

Make your check payable as follows:

The G.I.R.S.

c/o Anthony Stein

4739 Belleview

Suite 304

Kansas City, Missouri 64112

If you would like to give a regular membership as a gift to someone, please provide the following information regarding the person receiving your gift membership:

*Name*
*Street Address*
*Address (cont.)*
*City*
*State/Province*
*Zip/Postal code*
*Country*
*Telephone*
*E-mail*
*URL*
Member Options
Payment:

	Gift Membership
*Name*
*Street Address*
*Address (cont.)*
*City*
*State/Province*
*Zip/Postal code*