Membership Application 2007-2008

Please Print : Name ____________________________________ (First) (Last) Today's date__________

Address __________________________________ Apt. No. _________ City _____________________ ZIP Code __________

Day Phone (____)____-____ Night Phone-If Different (____)____-____ Cell Phone (__)____-_____

FAX Phone (____)____-____ Email ________________________________

Birthday Month/Day ___/___

NEW ___ or Renewal ____ (Member since _____ or Charter Member ____ )
Active $30 __ Senior (62+) $18 __ Youth (to 18) $15 __ Newsletter Only $12 __

To save postage/printing expense, email newsletter distribution will begin in November.
(We will continue to print and mail as usual to those who decline email distribution.)

Please indicate if you are willing to receive your newsletter by email only to your
email address listed above.
YES ___ NO ____

Friendship/Mini Group
Name of Group I belong to ________________________
I would like to join a Group: Day ____ Evening _____

Participation
(SMQG needs your help! Please check if you can help.)

Thank you.) Hospitality ___ Membership ___ Ways & Means ___ Programs ___
Library ___ Quilt Show ___ Historian ___ Philanthropy ___ Guild Activities ___

Please bring this form to the next guild meeting or mail to:
SMQG Membership,
c/o Sherry Kleinman, 17239 Avenida de la Herradura, Pacific Palisades CA 90272

For Membership Committee Only

Date: ________ Amt. Rec’d $ _____ Check No. _____ Cash ____