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Cauliflower Alley Club - Membership Application/Renewal
** Fill out this form, then print it on your printer **

Name
 Professional Name
Street Address
 City
State
 Zip Code
Country/Postal Code
 Telephone
E-Mail Address
 Birth Date
Describe Involvement in Wrestling or Boxing
Membership Level - United States
1 Year - $25 2 Years - $50 Lifetime - $300
Membership Level - Canada & Mexico
1 Year - $25 1 Year w/ newsletters - $35 Lifetime - $450
Membership Level - Overseas
1 Year - $25 1 Year w/ newsletters - $45 Lifetime - $550

Anyone can join the club.   You do not have to be involved in a ring-related profession, but let us know what you do, and send a photo and short biography for our countries, dates, etc. on a separate sheet or the back of this form.   We welcome photos, clippings, etc.

Enclose your check or money order for the dues donation, the amount depending upon whether you live in the U.S., Canada/Mexico, or elsewhere, plus any additional (tax deductible) donation, and mail to:

Cauliflower Alley Club, HCR 33, Box 107, Rolla MO 65401
PHONE (573) 729-2775, FAX (573) 729-7998

Upon receipt of dues, your new membership card and parchment membership certificate will be mailed.