Northwest Sampler Guild

Membership and Renewal Application

 

 Active Member  $ 30.00
     (all benefits)
 Associate Member (US and Canada)     $15.00
     (quarterly newsletter & one activity/year)
 Associate Member International   $20.00
 Sustaining Member     $50.00
     (tax deductible donation of $20.00)
Patron    $100.00
     (tax deductible donation of $70.00)
 
My check for _____________________  Date ____________ made payable to Northwest Sampler Guild is enclosed.

Check the label on your newsletter to see the month you joined. Pay your renewal dues on the first of that month each year.

 

_____________________________________________________
NAME

_____________________________________________________
ADDRESS

_____________________________________________________
CITY

_____________________________________________________
STATE                                                              ZIP PLUS FOUR

HOME PHONE   (     )__________________________________

WORK PHONE  (     ) __________________________________
  
E-MAIL ADDRESS  __________________________________


HOW DID YOU HEAR OF NSG? _______________________ ____________________________________________________

 

Print this form, fill it out and send it with check/money order (in U.S. Funds) to:

NORTHWEST SAMPLER GUILD                Membership 
5363 Bellaire Way, Bellingham, WA 98226-9029

Or, pay your dues online!

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