_______ I am currently a member of The Fostoria Glass Society of America

   _______ I am not a member of The Fostoria Glass Society of America and would like to join. Annual dues for FGSA are

   $16.00 for each applicant.

   All members of the FGSTN must be members of the Fostoria Glass Society of America.

   To become a member of the Fostoria Glass Society of Tennessee please

   print this form, complete the information and mail with $10.00 for each applicant to:

   The Fostoria Glass Society of Tennessee,113 Saint Marys Court,Smyrna, TN 37167

   MAKE CHECKS PAYABLE TO: FOSTORIA GLASS SOCIETY OF TENNESSEE OR FGSTN.

   __________________I am inclosing a check for FGSTN dues only.

   _______________I am inclosing a check for FGSA and FGSTN

   If payng dues for both organizations make check payable for $26.00 for each applicant and we will forward your dues to FGSA

   and a copy of this form.   Name (print)_________________________________________

   Address _________________________________________

   City____________________________________State_________Zip_________

   Telephone (___ )_____________________      E mail address:____________________________________________