RUSTY WISE FANCLUB MEMBERSHIP FORM

With your paid membership you will recieve ...

  • NewsLetter
  • Postcards
  • Pictures
  • Membership card / certificate
  • & much, much more

    Individual Membership.......................$10.00
    Family Membership...........................$15.00

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    print this page, and return this portion with your check or money order

    (For VISA / MasterCard), Call 1-888-396-0636

    To:   RUSTY WISE FAN CLUB
            PO Box 1122
            Cherryville, N.C. 28021

            please print clearly

    Membership Type:

    New__________Renewal_______Family______(Limit of 4)

    Member's Name_______________________________________________

    Street Address________________________________________________

    City____________________________State_______________Zip_______

    Home Phone (________)__________________________________________

    If this is a family membership, list the names of the family members other than yourself:

    1._________________________________ 2.____________________________

    3._______________________________________________________________


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    Please allow 3 to 4 weeks for delivery of Fan Club Material

                   thank you!
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