APPLICATION FOR MEMBERSHIP

Dues per Year $15.00 US Single - $20.00 US Couple ($10 US yearly if only a subscriber to our monthly newsletter)

Date_______________________

Performing Member___Supporting Member___

 Instruments______________________________________ ________________________________________________ ___Vocalist ___Band Leader

NAME(s)_________________________________________

 ADDRESS________________________________________

 CITY________________________STATE___ZIP________

 PHONE_________________E-MAIL__________________

BIRTHDAY_____________________(MONTH/DAY)

MALE/FEMALE__________________

ANNIVERSARY__________________

 SIGNATURE______________________________________

 REFERRED By____________________________________

 Check # ___________ Money Order__________

Western Swing Society Approval______________________