POETRY SOCIETY OF OKLAHOMA                                                                                      

MEMBERSHIP FORM

Office Use

Please initial

Only

Date Rec’d

 

Date Recorded

 

#Check

M.O.

Cash

 

 

Name____________________________________________________

(As you want it to appear in the yearbook)

 

Mailing Address_________________________________________________

    (Street No./Box No.)

 

_______________________________________________________

                                    (Please include City, State, Zip Code)

 

TelephoneNo.(_____)_______________E-mail____________________

 

Do you want your E-mail Address published in yearbook? _____Yes _____No

 (If not checked, E-mail address will not be published)

 

Type of Membership:______Regular ______Life ______Student (Check one)

 

Make checks payable to Poetry Society of Oklahoma, or PSO

 

Send checks to: Mikki Pennington

 Membership Coordinator

 P.O. Box 7842

 Moore, OK 73153

NOTE: Membership dues are: Regular Member-$20.00/year Student Member-$7.50/year

Do you belong to any other State Poetry Society?_____yes _____no (please check one)

If yes, do you receive the NFSPS newsletter,Strophes,from that Organization? ______yes ______no (please check one)

 

Become a PSO Donor!  To become a PSO Donor, make a Contribution above your dues and Sponsorship Fees. Please specify category on your check and mark it below:

 

PSO Angel: $150 +            __________                Oklahoma Rose: $100 - $149            __________   

                       

Rose Rock: $75 - $99            __________    Indian Blanket: $50 - $75            __________   

 

Red Bud: $25 - $49            __________                                         Thank you for your donation to PSO!

 

 

 

 

You can down the PDF file here.