MEMBERSHIP APPLICATION                       

                                 Membership Dues (Individual or Family).......See prorated fees at left
                                  Company.............................................................................................$90.00
                                      (Includes a business card sized listing in the newsletter)
                                  Please accept my payment of $______________  for membership
                                  in the Rocky Mountain Koi Club for which I will receive all the benefits
                                  and newsletters.

                                  NAME________________________________________________________

                                  ADDRESS_____________________________________________________

                                  CITY_________________________________________________________

                                  STATE________________________  ZIP____________________________

                                  PHONE (H)____________________________________________________

                                  PHONE (W)___________________________________________________

                                   E-MAIL______________________________________________________

                                  Please Circle One:         NEW MEMBER                              RENEWAL



Send payment to: Rocky Mountain Koi Club, P.O.Box 461, Englewood, CO 80151-0461
Visit us at:
www.rmkc.net
Include me in the Member's Directory, which is mailed to the membership    (circle one)  YES    NO
Prorated Fees:

Jan - Feb            $12
Mar - Apr            $42
good for 14 months
May - Jun           $36
Jul - Aug            $30
Sep - Oct            $24
Nov - Dec           $18
PRORATED FEES
ARE FOR NEW
MEMBERSHIPS
ONLY.  RENEWALS
ARE $36 PER YEAR