Part 1: Membership Data

Membership Type: 

New    Renewal  


Primary Name for  
Membership/Subscription: 


 

(full name as you'd like it to appear on mailing labels)

Secondary Name for   
Membership/Subscription:  


 

(if applicable -- spouse or other adult in household)  

Your Email Address: 

Phone (222-222-2222): 

Mailing address for newsletter: 
(street or PO Box)  

City: 

State:

Zip: 

Interests: 
(check all that apply)  

Newsletter
Concerts
Festival
Housing Performers
Publicity
Membership
Transportation
Other - contact me (or enter comment below)

I would like to receive my  
confirmation of membership by: 

Email     US mail

   

Comments:  

 


or  

        

 

     

    (c)2003 Madison Folk Music Society