Department56   
1998-1999
"Orly's Friends"
sponsored by
The Thoughtfulness Shop
104 Cass St.
Woodstock, IL  60098
Phone:  815-338-5651 or 888-695-5656
Fax:  815-338-6666

Date:    _____________________________  

Instructions:

• Please print this form, then fill out and mail to the address provided above.

• Annual dues $15.00

• Expires October 31st  1999

• Membership not transferable

• Please make check payable to: Orly's Friends

• Dues paid by:  Check __  Cash __

Name:    _____________________________  

Address:    ____________________________   

City:    _____________________________  

State:    __________Zip:_______________   

Home Phone:    ____________________________   

Work Phone:    _____________________________  

Signature:    _____________________________