The WEDGWOOD SOCIETY OF SOUTHERN CALIFORNIA
P.O. Box 4334 • Palm Springs, CA • 92263
MEMBERSHIP APPLICATION
NAME________________________________________________________________

ADDRESS_____________________________________________________________

CITY, STATE/PROVINCE________________________________________________

ZIP/POST CODE___________________________________COUNTRY____________________

E-MAIL (Opptional): ____________________________________________________
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INDIVIDUAL: $20.00
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TWO OR MORE AT ONE ADDRESS: $30.00
*NEW MEMBERS JOINING AFTER JULY PAY HALF THE ANNUAL DUES
PLEASE MAKE YOUR CHECK OR MONEY ORDER PAYABLE TO:

THE WEDGWOOD SOCIETY OF SOUTHERN CALIFORNIA
P.O. Box 4334
Palm Springs, CA 92263