Membership Application - 2011
(please print clearly)

Please print clearly, especially your email address!!

Name(s) __________________________________________________________

Street Address                                                                          _________________

City State Zip                      _

Home Phone

Studio/fax/other phone

email                                                                                       __

Website                                                                                    _

$              _   Regular Membership $20

$ _________ Donation to Clay in Education

$ _________ Total enclosed

Circle one: renewal or new member

We prefer to use the internet to correspond. If you absolutely need your info to come to you via U S post Office please check this box, otherwise we will contact you via your email account. ____

Thank you! Please make check payable to Clay Guild of the Cascades. Mail to:

Clay Guild of the Cascades
P.O. Box 172
Bend, OR 97709