Membership Application

Please print this application, fill out, and mail with your check to:

Society of St. Romanos
933 N. LaSalle St.
Chicago, Illinois 60610

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I wish to join the Society of St. Romanos. Please enter my membership in the following category (check one):

Individual Membership: $30	Artist’s Circle: $500–$999
Family/Couple: $50	Benefactor: $1,000–$1,999
Contributor: $50–$99	Patron: $2,000 and up
Donor: $100–$499

I would like to join the Volunteer Board.

 

Name
Address
City, ST, ZIP
Phone
E-Mail

Thank you for your support!