Oliver Gang Membership Application/Renewal Form

Print out this form and then fill in your information on the following lines.

Name: (required)________________________________________________________________

Spouse and children's names: (optional)______________________________________________

Address: (required)______________________________________________________________

City, State, ZIP or postal Code: (required)____________________________________________

Country: (required)______________________________________________________________

Phone: (optional) _______________________________________________________________

E-Mail Address: (optional)________________________________________________________

The membership list is included in the newsletter occasionally so that members may be able to contact each other. The Oliver Gang will not sell, rent or give away your information. Please check the appropriate box.

YES, You may publish my contact information in the Chapter One News.

NO, I do not want my contact information published in the Chapter Ones News.

A membership in the Oliver Gang is $5 (US) per year.

I am signing up for 1 year and have included payment of $5

I am signing up for 2 years and have included payment of $10

Send the form above with your check or money order made payable to "The Oliver Gang" in US funds to:
The Oliver Gang
c/o Chris Losey
11326 N. Parma Rd.
Springport Mi. 49284