logo.gif (5181 bytes) AAM, INC. Membership Application / Merchandise Order Form
 
 
MEMBER INFORMATION
Name:
Address:
City/State/Zip:
Email:
Phone:
Is this an address change or correction? Yes No
ORDER INFORMATION
$100.00  Includes: One year Sustaining Membership (includes vote at meetings), AAM Newsletter for a year, 1979 Tractorcade tape, and the paperback book: One Man With Courage, The Wayne Cryts Story.
$50.00  Includes: AAM Newsletter for a year and 1979 Tractorcade tape.
$47.00  Includes: 1979 Tractorcade tape, and the paperback book: One Man With Courage, The Wayne Cryts Story ($40 plus $7.00 S&H).
$29.00  For: 1979 Tractorcade tape ($25 plus $4.00 S&H).
$25.00  For: AAM Newsletter for a year.
$21.25  For: One Man With Courage, The Wayne Cryts Story, paperback book ($15 plus $6.25 S&H).
PAYMENT INFORMATION
Payment Type:
Name on Card:
Exp. Date: Month/Year
Card Number:
Please note: for your protection, this is a secure form. All information entered here is encrypted while in transit over the Internet.

If paying by Check or Money Order: Please print this screen, enclose the total from above, and mail to:
Jim Rice, AAM National Treasurer, 11232 Rd. K, Liberal, KS 67901
The American Agriculture Movement, Inc. thanks you and welcomes you as a member.

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