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GIFT MEMBERSHIP (* Required fields)

Use this form to give a GIFT MEMBERSHIP FOR THE HOLIDAY SEASON 2009! New Membership runs through January 1, 2011!

We will send a welcome letter for the person receiving your gift direct to you to present to your gift recipient.

Please note that this is a two stage process. After completing the form below, your gift recipient's name will be entered into the database and you will receive a confirmation email. You will receive a second confirmation if you complete your renewal by paying on line.

Name and contact information of person for whom you are buying a membership
Title:
(Mr; Ms, Dr. etc.)
First Name:*
Initial
Last Name*
Company/Libary or Institution:
Department
Address:*
Address:
Address:
City:*
State/Province:
Postal Code if applicable:
Country:*
Office Phone:
Home Phone
Fax:
Recipient's Email if known
 
Membership category:
GIFT GIVER'S INFORMATION (Person giving and paying for the gift membership)
Your Name (person giving the gift) - First Name
  
Last name  
Your Email* Required
 
Your IPS account number (if known)  
Is this a new or renewal gift membership?  
RESIDENTS OUTSIDE MAINLAND USA ONLY - PALMS JOURNAL DELIVERY
How you would Palms Journal delivered: Direct Air (included in Annual fee) or
Member Directory: Click here if you DO NOT WANT the gift recipient to be listed in the directory
How will you be paying?

ONLY HIT THE SUBMIT BUTTON ONCE.!
Information is writing to our database and may take a few moments

 

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Genera Palmarum II

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Interim IPS Board Meetings
2011 - Tenerife, Canary Islands