| Please print this
form and mail it to:
Tara Nelsen
2026 Clarke St
Murphysboro, Illinois 62966
Membership in SIPA is $10.00
or $15.00 annually. For $15.00 over $10.00 you get an official
SIPA Logo item you can slap on your car, folder,
book of shadows, or neighbor! How fun is that? The costs
are to help us cover newsletter and duplication costs,
as well as costs associated with our web site, running
events, etc. Also with each membership you will recieve
your very own membership card.
Please make checks
out to Tara Nelsen
Name:
_____________________________________
Address:
_____________________________________
_____________________________________
City: ________________________________
State: _____
Zip Code: ___________
Phone (_____) ________ -
___________
E-mail: ______________________________
Date: ___ / ___ / ___
Briefly describe your path
and interests:
I would rather be contacted about SIPA related news and
events by:
E-mail ___
Phone ___
Mail ____

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