Please Complete and Mail to Quashnock@aol.com or:

James Quashnock
ROS Membership Secretary
3575 State Highway 258 E
Wichita Falls, TX 76310 - 7037

Please Print or Type:
Ms./Mr./Mrs./Dr./Prof. (please circle)
Name_______________________________________________________________________
Street_______________________________________________________________________
City ___________________________State______________Zip Code___________________
Country_________________________
E-mail address______________________________
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Memberships commence January 1, and are renewable by December 31, annually.
Dues enclosed for the year 20__

Annual Dues $30.00  (USA)
            $40.00  (Canada)
            $50.00  (Outside North America)
*Tax Deductible Contribution __________________
             Amount enclosed __________________

Please make check or money order payable in US Dollars to: The Reed Organ Society.
*Contributing Member – to $ 24.00; Supporting Member - $ 25.00 to $49.00; 
Sustaining member - $ 50.00 to $99.00; Patron - $100.00 and over.  
Electronic Membership Forms will be kept for 30 days  pending payment of dues.
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Please complete the Information Below for our Membership Directory

The information below will help us to know you better and be used to complete the annual Directory. Provide as much information as you wish.
Telephone: Business (____)_________________ Home (____)_______________________
Profession or Occupation:_____________________________________________________
How did you hear about the Society?____________________________________________

Author - have written books/articles (Y/N)
Antique Dealer (Y/N)
Have reed organ advertising materials (Y/N)
Amateur organist (Y/N)
Buy/Sell reed organs (Dealer) (Y/N)
Actively collect reed organs (Y/N). How many?___
Make custom parts for reed organs (Y/N)
Collection open for viewing either with or without appointment (Y/N)
Have reed organ catalogues (Y/N)
Do historical research (Y/N)
Can help with identification /appraisals (Y/N)
Have reed organ music (Y/N)
Professional organist (Y/N)
Interested in making reed organ recordings (Y/N)
Restorer - Hobbyist
Restorer - Professional
Sell reed organ parts (Y/N) (Please specify)_________________
Tune reeds (Y/N)
I perform regularly on a reed organ (Y/N)
Special Knowledge ____________________________________________________________
Can contribute articles for the ROS Bulletin? (Y/N) Subject__________________________