To join in 3 easy steps:

1. Print out this page.

2. Fill out the information and write your check out to: North Coast Parrot Head Club

3. Mail both to:
North Coast Parrot Head Club, P.O. Box 31451,
Independence, OH 44131

Name: _________________________________________

Address: _______________________________________

City, State, Zip: __________________________________

Phone:  _________________________________________

E-Mail: ________________________________________

Birthday(s):_____________________________________

Favorite Buffett or phlocking memory:______________________________________

______________________________________________________________________

Favorite Charity:_______________________________________

How you heard about the Club:______________________________________________

________________________________________________________________________

T-Shirt Size(s): M L XL  XXL

 This contribution is not deductible as a charitable contribution for federal income tax purposes.

Family Membership: $45/year (includes 2 t-shirts for first time members)

Single Membership: $35/year (includes 1 t-shirt for first time members

The membership year is July to July. Memberships received during the year can be prorated.

Extra T-Shirts: $15 each