2008 DUES RENEWAL

CHECK YOUR EXPIRATION DATE ON THE MAILING LABEL. IF IT DOES NOT SAY 2007 YOU ARE NOT PAID UP AND MAY BE DENIED ENTRY TO AN EVENT OR MEETING.

Emerald Society Member ID# ______________  

(PLEASE CHECK YOUR  ID CARD  OR  NEWSLETTER MAILING LABEL)

Name: Last __________________________________________________________________________

First ________________________________  Middle ___________________________________

Address __________________________________________________________ Apt # ____________

City, State, Zip _______________________________________________________________________

E-Mail Address ______________________________________________________________________

Home Phone:______________________________    Work Phone: ____________________________   

Department/Unit______________________________________________________________________

 (Please check only one):    New Member ____    Renewal ____   Associate ____       Annual Dues $30.00     (New Member Special for 2008 $15.00)

  New address  _____    Retired ______   (Retired members are not required to pay dues, but must return this form.)

Please remit check payable to:   Emerald Society of Illinois, P.O. Box 557819, Chicago, IL 60655-7819

Please fill out completely and legibly so you are sure to receive newsletters.    Also, please check the label on this letter for errors. If you are renewing make any changes above. If you are current and there is a need for change please inform Jim McCarthy at the above P.O. Box, or by telephone at 847-336-6939, or email me at: JimMcCarthy@EmeraldSocietyofIllinois.org .