Please Print

Name ______________________________________________________________________________

Address ___________________________________________________________________________

City ____________________________ State/Province _________ Postal Code ____________

Country ___________________________________________________________________________

Phone ___________________________________ Email ___________________________________

ISFGW no longer has annual Membership fees in different categories. Each member and
Honorary member pays WHATEVER he or she can afford. Please indicate amount below by
a check mark:

(  ) $10     (  ) $25        (  )  $50       or   $ ______________.

Please mail this Application and your check payable to ISFGW to

Dr. Stanley Drake, President Emeritus
205 S. Bickett St.
Burgaw, NC 28425 USA

and he will send you a Certificate naming you an International Good Will
Ambassador of ISFGW, together with several items of interest to all 
Esperanto speakers.