ANCASTER QUILTERS GUILD

Member Information and Declaration Form

 2022-2023

PLEASE PRINT!!!!

NAME: ____________________________________

ADDRESS: _____________________________

CITY: __________                 

Postal Code:________               

PHONE:____________________________

E-MAIL :  _______________________________

MEMBERSHIP FEES:

NEW MEMBER: $ 45.00 (Includes name tag)   RENEWAL $40.00

CASH ____________ CHEQUE_____________E-Transfer__________ 

PLEASE MAKE CHEQUES PAYABLE TO: “ANCASTER QUILTERS GUILD”

NO POSTDATED CHEQUES PLEASE

DISCLOSURE:

DO YOU AGREE TO HAVE YOUR NAME PUT ON OUR MEMBERSHIP LIST FOR DISTRIBUTION OF THIS LIST TO OUR GUILD MEMBERS?

YES________ NO__________

DO YOU AGREE TO HAVE YOUR NAME POSTED IN OUR NEWSLETTER AND/OR ON OUR WEBSITE?         YES_________NO__________

DO YOU WISH TO RECEIVE THE NEWSLETTER BY E-MAIL?  YES:_____NO:_____