Steiff Club Application

*First Name:
*Last Name:
*Address:
*City:	State: Zip:
*Phone:
*E-mail:
Date of Birth
*Please Check What type of membership
This is for myself Gift Membership

This gift membership is going to:

*First Name:
*Last Name:
*Address:
*City:	State: Zip:
*Phone:
*E-mail:
Date of Birth


Comments or message to gift recipient

Dolls and Daffodils 245 Legris Ave, West Warwick RI 02893