The Internet Chapter of the American Needlepoint Guild

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Wild Rose Sign Up Form

You must click on the submit button to process your registration. It MUST be sent electronically even when paying by check. You may include a printed copy with your check if you so desire, it can be helpful in matching your payment to the form, but it must still be submitted by clicking on the submit button.

Cost is $3.00 for US and Canadian addresses, $3.50 for international addresses; payable in US funds.
Please use the Street Address that you want the instructions mailed to.

First Name:
Last Name:
** Email Address **
** Note: Please use the email address that we have on record for you, this should be the one you gave us on the membership form. This currently is the only way we have of making sure only legitimate members get the benefits of the chapter. **
Phone number
Street Address
Street address - line 2
City
State/Province (put 00 if no state)
Postal or ZIP code
Country
Paying for Wild Rose fees via	Paying by PayPal Mailing a check or money order
This form MUST be submitted electronically even when paying by check.
By submitting this form I confirm that I have read and agree to the Education Policies.