CLUSTERED SPIRES QUILT GUILD

MEMBERSHIP FORM

NAME:  ____________________________________________________

STREET ADDRESS: ___________________________________________

CITY: _____________________  STATE:_______  ZIP:______________

Are you new to the area?  Yes            No              

If so, where did you move from?  _______________________

HOME PHONE: ___________________ CELL PHONE: _________________

WORK PHONE: ___________________

E-MAIL:_________________________________________________

DATE OF BIRTH:    MONTH: ______________DATE:   ______________

Are you new to quilting?    YES: ____  NO: ____

If No, how long have you been quilting? _____

Have you previously belonged to a quilt guild?  Yes_____        No_____

If yes, name and location of guild  _________________________

What are your expectations of a quilt guild?  ___________________________

_______________________________________________________________

How did you hear about our quilt guild?  ______________________________

_______________________________________________________________

Skills you would like to learn or improve:  ______________________________

________________________________________________________________

Suggestions for programs/speakers/workshops:  ________________________

_______________________________________________________________

Skills you could share with guild members:         ________________________

DUES PER YEAR (JANUARY THRU DEC):                             $25.00

SNAIL MAIL POSTAGE (FOR NEWSLETTER):           $5.00

AMOUNT PAID:_____________________              DATE: _________

CASH: ____________   CHECK NO:_________