- Please print and mail to :
- Make Check or Money Order for $10 US Currency, Payable to: "Barbara Szijarto"
- Mail to:
- World Wide Gnome Association
- 2838-135 Avenue
- Edmonton, Alberta T5A-3S4 Canada
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- PUT IN 'COMMENT' section when paying via paypal, put your Full name, mailing address, phone, email, URL (if have one), date of birth, and your gnome name of choice. this way we can process the application quickly. (otherwise you'll need to cut and paste this application and email it with the answers)
- NOTE use: lylew@telusplanet.net for paypal. Thankyou.
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IMPORTANT!! PRINT NEATLY if we can’t read it you can’t receive it!!
- Name:____________________________________________________
- Gnome Name: 1st choice ___________________
- 2nd choice__________________
- Email: __________________________________________________________
- Your website address:_______________________________________________ (if exists)
- Personal information on this form is for club use only, we don’t sell ANY information.
- Ours is a child safe rated site and organization If you have any special requests let us know.
- Mailing Address:
- _______________________________________________________________
- _______________________________________________________________
- _______________________________________________________________
- _______________________________________________________________
- Birth Month ______________ Day ___________Year________(optional)
- Sex: (check box) r Male r Female (check box) Adult: r Yes r No
- Phone (optional): __________________________________________________
- I hereby state: As a member I will not give out other members names and email addresses. I will keep the passwords secret and promise to be an honorable member in good standing or otherwise risk the wrath of the little people! I agree to the terms of Membership.
- Signature ______________________________________ Date ___________________
- Minor members please get guardian/parents signature:
- ______________________________________________________________