International Modena Club
Established 2003

2012 Membership - Apply by Mail
(Resident: Outside the USA)

Please click the boxes below & type information, print completed form, sign and mail  
with money order in US Dollars to the address at the bottom:

Any person of good character is eligible to apply for membership to the IMC by meeting the following criteria:

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    membership application has been completed and submitted to the Secretary/Treasurer,

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    has paid the applicable membership fee,

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    has agreed to comply with the Bylaws of this club and signed their membership application to abide by the governing rules of the organization,

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    A member's application for acceptance to the IMC is dependent on the Board of Director's approval by a two-thirds majority vote and their decision is final.

Name:

E-Mail Address:
Spouse:

Address:

Address:

Address:

City & or
Province:

Postal Code:
Country:

Phone Number:

Date of Birth:
(Mo/Day/Yr)

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Have you been a member of the IMC in the past?
If yes, what was your IMC #?
Do you belong to other pigeon organizations?
If yes, please list them:
Start my membership now!

Upon acceptance, my membership will run through December 31 of the current year.
Start my membership next January 1

My membership will begin January 1 of the coming year.
I want to receive The IMC Quarterly electronically online

I will be issued a User Name & Password for online access to The IMC Quarterly.  In addition, I will have access to previous issues.
I want to receive The IMC Quarterly by mail

I will receive my issue of The IMC Quarterly by mail delivery.

I understand and agree to abide by the rules of the IMC and agree to be bound by this membership agreement between the IMC and myself in the future.  If the Board of Directors finds me at fault for not abiding by the IMC Bylaws, I understand my membership privileges may be suspended or terminated as directed by the Board of Directors and I hereby hold the IMC and the Board of Directors harmless.

 Applicant's Signature: _______________________               Date:_____________

Welcome to the Currency Converter:
The IMC allows members living outside the USA that receive The IMC Quarterly online to pay an equal amount for their membership based on the current exchange rate.  If you wish to receive The IMC Quarterly by mail then simply check it below.  If you want to receive The IMC Quarterly online in color, please convert your currency to US Dollars and enter that amount in the box below marked "Enter Converted Price" next to the membership of your choice.  To convert your currency to US Dollars, follow these steps and enter the amount as described below:

To Print these Instructions, Click Here:

Step 1. Note the price in US Dollars shown below in red next to each membership description and select the membership you wish to purchase.

Step 2. Click for the Currency Converter and enter the amount of your membership (For example: $30.00) in the "Convert" box.

Step 3. Select your country from the list in the "From this Currency" box.  Be sure to select the correct country and currency.  For example, if your country and currency is South Africa Rand (ZAR), select them. 

Step 4. Now select United States, Dollar (USD) in the "To this Currency" box and click "Go."  This will convert your currency to an equal amount in US Dollars based on today's exchange rate.  Click your "back arrow" to return to this page.

Step 5. Enter the quantity for the membership you want to purchase in the box below to the left of your membership selection.

Step 6. Insert the converted price in the box to the right of the membership you want to purchase.  (For example, if you converted $26.25 shown below in red, enter the converted price in the "Enter Converted Price" box.  Do not enter the dollar sign.  The converted price is the amount that will be charged to your Visa or MasterCard in US Dollars.  This transaction will be shown as "International Modena Club" on your credit card statement.

Step 7. Click the "Continue" button at the bottom of the form and follow the directions to pay your membership online with Visa or MasterCard.  Your personal information is never compromised on the IMC's secure server.

Note: If your country's converted price is more than the US Dollar amount shown below in red, you may elect to pay the lesser amount.  (For example, if the converted price is $50.00 in US Dollars you may elect to pay the amount in US Dollars instead ... whichever is less.)
Please enter the converted price below.  Note that if you wish to receive the Quarterly by mail it must be paid in the amount shown due to the additional costs for printing and postage from the USA.
Membership
Choice

Description

Enter
Converted
Price
2012 Adult Membership Outside the USA - Quarterly Online ($30.00)
 For individuals outside the USA who wish to receive The IMC Quarterly, ballots, and published material sent to them online, the membership fee is $30.00 in US currency, and may be paid online by credit card.		 $
     
2012 Adult Membership Outside the USA - Quarterly by Mail (Hardcopy)
The individual membership fee for members receiving The IMC Quarterly by mail is $40.00 US Dollars.  This fee entitles the member to all rights within the IMC, which includes voting, holding office and participation in all club shows and activities, as well as all club publications such as The IMC Quarterly.  The additional fee is for added costs in printing and postage from the USA.

     $40.00
     
2012 Spouse Membership Outside the USA ($15.00)
 Spouses of members in good standing who meet the requirements for individual membership may join the club for a $15.00 membership fee, but will not be eligible to vote or hold office, and will not receive separate mailings of club information.  However, the membership entitles them to attend events and enjoy the other benefits of the club.  Spouses who wish to have voting privileges must join under an individual membership and pay the appropriate membership fees.		 $
     
2012 Junior Membership Outside the USA ($20.00)
 Individuals who are 18 years old or younger on January 1 and meet the other requirements for individual membership may join as junior members for a fee of $20.00, and will be entitled to full individual membership privileges.  Any junior member between the ages of 12 and 18 will be allowed full voting rights and privileges.		 $
     
2012 Affiliated Club Membership Outside the USA ($30.00)
 Any organization devoted to the Modena pigeon may become a member of the International Modena Club by applying to the Secretary/Treasurer and paying the membership fee of $30.00 per year.  Affiliated Clubs shall not have voting privileges in any IMC election.		 $

This portion to be completed by the International Modena Club:

Date application was received: ______________________________ Approved

Disapproved

Mail Completed Form with Money Order in US Dollars To:

International Modena Club
10032 Goodrich Road
Bloomington, MN 55437-2413 / USA