Last Name :________________________ Year of birth:_________________ First Name:_________________________ Age this year:_________________ Address:_________________________ Religion:_________________ :_________________________ Occupation:_________________ City:_________________________ [ ] Male [ ] Female State:_________________________ [ ] Single [ ] Married Country:______________ Postal Code:___________Email Address:_________ ----------------------------------------------------------------------- Correspondance Preferred [] Male [] Female [] Both In which languages do you wish to correspond: ENGLISH Plus 2[]French 3[]German 4[]Chinese 5[]Italian 6[]Japanese 7[]Portuguese 8[]Russian 9[]Spanish ----------------------------------------------------------------------- Have you ever been a member of our club? [ ] Yes [ ] No How or where did you hear about us?____________________________________ ----------------------------------------------------------------------- Which Items in general interest you? 1[]Art 2[]Animals 3[]Athletics 4[]Boating 5[]Business 6[]Camping 7[]Cinema 8[]Computers 9[]Crafts 10[]Dancing 11[]Exchange Vacations 12[]Fishing 13[]Frank Discussion 14[]Games 15[]History 16[]Liturature 17[]Languages 18[]Music 19[]Photography 20[]Poetry 21[]Reading 22[]Science 23[]Sport 24[]Theatre 25[]Travel -----------------------------------------------------------------------Select at least 2 Regions in which you want to have PenFriends
Region 1 [] North America Region 7 [] Middle East Region 2 [] Central America Region 8 [] Southern Asia Region 3 [] South America Region 9 [] East Asia Region 4 [] United Kingdom Region 10 [] Africa Region 5 [] Western Europe Region 11 [] Australia & Pacific Region 6 [] Eastern Europe ALL [] All Regions ========================================================================= MEMBERSHIP [] P1 - One Person....Aged (6-98) Fees may be paid by cash, U.S. Check, $20.00 U.S. or 34 IRC ** Money Order or IRC and should be made payable to: IPF Please return this form with fees to: International PenFriends PO BOX 789 CHELAN, WA 98816-0789 USA
MEMBERSHIP- You will start by recieving a list of 10 PenFriends that you will write first. Membership lasts one year and during that time your name will appear on ten other member lists who will write to you first. Giving you as many as 20 PenFriends who will be in your own age group, capable of writing at least one language you have in common and have similar interests.
** (IRC) = INTERNATIONAL REPLY COUPON. Available at any Post Office / Type CN 01
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