Please print information as you wish it to appear on the website and name badge Birth Date: Address: Tell us About you:

Member Registration Form

Shirley Club USA is growing and you play an important part as we expand around the WORLD! Your New Member Kit will include an official membership shirt, name badge, 15 social cards, and quarterly newsletters.

See below for totals and shipping information at time of registration.
Keep My Email Private Measurement of Membership Shirt – armpit to armpit: City: State:
Only USA residents of Shirley Club USA can have their city name engraved on their badge. Everyone else gets International Members
Please indicate the city for your name badge:
Zip: Same As Address Alternate : We ship your New Member Kit via the U.S. Postal Service. The cost for shipping USA is an additional $7.00.
Member Information Mailed within the USA your joining cost is $32.00 (Includes Shipping
and Handling)

If mailed overseas, including Canada, the joining cost is US $50
(Includes Shipping and Handling)

All Annual renewal dues are only US $10.
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