| Credit Card Application Through a secure Pay Pal transfer (you do not need a Pay Pal account to do this) OR, print & send in the application below via regular mail IPAT Membership Rates U.S.A. Residents Current IPAT Member's Yearly Membership = $42.00_____________________________________________________> New Member or Renewal of Membership = $47.00*_____________________________________________________> NON-U.S.A Residents Current IPAT Member's Yearly Membership = $47.00 (includes out of country mailing but does not include airmail rates)_______________________________________________________> If you live in Canada and want to add l air mail service added ($16.00) click here____________________________________________________> If you live in Mexico and want to add air mail service ($21.00) click here________________________________________________________> If you live in Australia, New Zealand and Japan and want to add air mail service ($42.00) click here_________________________________________________> If you live in any other country other than those above and you want to add air mail service ($36.00), click here______________________________> New Member OR Renewal of Membership = $52.00* (includes out of country mailing - but does not include airmail rates)__________________________________________> If you live in Canada and want to add air mail service added ($16.00) click here___________________________________________________> If you live in Mexico and want to add air mail service ($21.00) click here_______________________________________________________> If you live in Australia, New Zealand and Japan and want to add air mail service ($42.00) click here_________________________________________________> If you live in any other country other than those above and you want to add air mail service ($36.00), click here_____________________________________________> All Checks must be payable through a U.S.A. Bank. Visa and Mastercard are accepted but no other credit cards are accepted other than these two (unless you have a Pay Pal account and pay via Pay Pal above). Membership dues are for one (1) calendar year which runs from January 1 - December 31. Dues are considered as delinquent on January 10th and membership will be on a renewal basis after that date. Mail or telephone payments to: IPAT, Inc. Box 1807 Grapevine, Texas 76099 Fax: 817-421-7643 Phone: 817-251-1185 Name: ________________________________________ Address 1:_______________________________________ Address 2: _________________________________________ Address 3: ________________________________ City: _________________________________ State or Province: __________________________ Zip Code: __________________ Country: _________________ Telephone: ________________ Fax: ___________________ E-mail: _______________________________________ Enter either your Visa or Mastercard information below: Visa Credit Card #:________________________________________ or Mastercard Credit Card #:___________________________________ Expiration Date: Month ___________ Year_____________ Type or Print your Name as it appears on your credit card NAME:________________________________________________ +++++++++++++++++++++++++++++++++++++++++++++++++ |
