To pay for your membership by mail, please do the following:
Please fill in the fields below.
Then print this form and send it by mail to the address above.
The Tuxedo Club
Check by Mail Form
For payment of -- please choose one of the Membership Options below:
From: Name and Street Address
(Full Name & Street Address where you want your Big Band's Alive CD to be shipped)
Message:
(Optional)
USD
Date:
Signature:
Press the Submit Button for High-Strength Encrypted (256 IBE!), Secure (SSL) Delivery
EncryptionMail by Secure Delivery -- Data maintained in Encrypted Form in our System.
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After Submitting or Printing, press the Reset Button to clear the form.
Charter-Starter Membership -- Good to 2006 -- $10
Check number:
Charter-Bonus Membership -- Good till end of 2007 -- $25
Lifetime Charter Membership -- Black-Tie privileges! -- $250
Benefactor's Kemosabe Club -- $1 or more (you decide amount).
Post Mail to: Stephen L. Gilbreath, The TUXEDO CLUB, 1428 Virginia Road, Hueytown, AL 35023-8417
205-491-7867 or 205-492-6879 E-mail: SLG@BigBandsAlive.com
