| Northwest
Sampler Guild |
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Membership
and Renewal Application
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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) |
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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.
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_____________________________________________________
NAME
_____________________________________________________
ADDRESS
_____________________________________________________
CITY
_____________________________________________________
STATE
ZIP PLUS FOUR
HOME PHONE (
)__________________________________
WORK PHONE ( )
__________________________________
E-MAIL ADDRESS __________________________________
HOW DID YOU HEAR OF NSG? _______________________
____________________________________________________ |
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Print this
form, fill it out and send it with check/money order (in U.S. Funds)
to:
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NORTHWEST
SAMPLER GUILD
Membership
5363 Bellaire Way,
Bellingham, WA 98226-9029
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Or, pay your dues
online! |
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