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Membership App

Membership Application

Name: ___________________________________________________________________

Address: _________________________________________________________________

City / State / Zip Code: _______________________________________________________

Phone: (______) ________________   Email: ____________________________________

Remarks: _________________________________________________________________



Dues are currently $20 per year. NEW! First time members only $10 for the first year. By being a member you can win hundreds of dollars in club prizes at club pipe smoking contests.

Premium membership is $30 per year, which also includes a free banquet and 10% discount on pipes and tobacco products at Kremers Smoke Shppe in Louisville.

Print out, complete and send this application along with check to:
Treasurer Jim Rudd, 3102 Lakewood Blvd., Jeffersonville, IN 47130.

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