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MEMBERSHIP APPLICATION
Please
mail your completed Application and cheque to: Box 56082, Valley Centre RPO Langley, B.C. V3A 8B3 |
| Fan Membership $30 (includes gst) | Industry Membership $40 (includes gst) |
| Corporate Membership $175.00 (includes gst) | Band Membership (4 members) $12 (includes gst, $40 each additional member) |
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Name: |
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Address: |
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Home Phone: |
Work Phone: |
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Cell Phone: |
Birthdate (m/d/y): |
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E-Mail: |
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Website: |
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| What's your involvement in Country Music? | ||||
| If you marked industry, please specify areas of involvement: | Production | Writing | Media | |
| Promotions | Booking Agent | Other | ||
| Are you interested in volunteering? | ||
| If Yes, what areas are you interested in? | ||
For Office Use:
| Member#: | Processed: | Renewal Date: |