| |
|
| Name:________________________________________ |
Date of Application: _________ |
| 2nd Person:____________________________________ |
New ( ) Renewal ( ) |
| Address:_______________________________________ |
Phone: ( )
______________ |
| City / State / Zip:________________________________ |
Email:_____________________ |
| Your Website URL:________________________________________________________ |
| |
Amount Enclosed: $40 for one membership ( )
$60 for two at same address
|
| I am a: Collector ( ) Beadmaker (
) Designer ( ) Dealer ( ) Other
( ) ______________ |
| |
| I am interested in working on the following: |
|
Newsletter ( ) Book Table (
) Bazaar ( ) Programs ( ) Membership
( ) Workshops ( )
Hospitality ( ) Hostess ( ) Advertising (
) Bead Challenge ( ) Other
( ) __________ |
| |
Make
check payable to The Bead Society
and mail with this form to: |
Los Angeles Bead Society
Attn: Membership Manager
P.O. Box 241874
Los Angeles, CA 90024-9674 |