Washington Bluegrass Association

New Membership and Member Renewal Form



Member Name:__________________________________________________    
Address: ______________________________________________________
City: __________________________________ State: ____________________ Zipcode: ____________
Phone: (     ) - _______________________ Email: ___________________________________________
Membership Category:
New Membership Renewal
Single Family (2 or more in family)
The One-year Membership rate for is $25/US or Canada.
This is a Gift Membership: From: (Name:)

__________________________(City:)_________________________
New Member: 1-year American membership ($25)
New Member: 1-year Canadian membership ($25)
Renew: 1-year American membership ($25)
Renew: 1-year Canadian membership ($25)
NEW MEMBERS Big Savings! 3-year Canadian or American membership $45
I'm in a band named: __________________________________________________________________
(All Payments must be made with U.S. Funds)
I play these instruments:__________________________________________________________________
(It is not neccesary to play an instrument or be in a band to be a member of the Washington Bluegrass Association.)
I'm willing to be a volunteer helper for:
Festivals
Publicity
Newsletter
Other:_________________________________________________
Complete and mail this form, with payment by check or money order (U.S. Funds) to:
Washington Bluegrass Association
Attn: Membership Application
PO Box 490
Toledo, WA 98591