Elsa's Fan Club Application

Name: _____________________________________________ Address:___________________________________________ Phone Number: ____________________________________ Email: _____________________________________________ Adult Membership - One Year - $10.00 ______ Child Membership - One Year - $5.00 _______

How are you paying?

Visa _____

Mastercard _____

Personal Check # _________

Pay Pal _____

Money Order ______

*I am just making a donation in the amount of $___________

Please allow two to three weeks for delivery of club packages, thank you! - eje

www.elsa-the-envirophant.com