To become a member of The International Institute of Antique Glass,

If you are paying by check please fill in the form below and submit.

Name

Address

City

State

Zip

Country

Phone

Email Address

Area of study/interest

I wish to pay by Check Make check or money order for $24 payable to:Steve Head

Mail to

Member - International Institute of Antique Glass

P.O. Box 1524

Mill Valley, Ca. 94941

email-head@linex.com