Please print and complete this form, then mail it to the address below.

 

MEMBERSHIP APPLICATION

The Bead Society of Greater Washington

and The Bead Museum of Washington, DC

 

____Yes! I wish to join the BSGW / BMDC              ____Please renew my membership.

                                                            

____________________________________________________________   Mrs.   Miss   Ms.   Mr.

NAME                                                                                                                                              PLEASE CIRCLE           

                       

__________________________________________________________________________________

ADDRESS

 

__________________________________________________________________________________

ADDRESS

 

_____________________________________________     ___________________________________

CITY                                                                  STATE / COUNTRY                                       ZIP CODE

 

__________________________________________________________________________________

PHONE (DAY)                                                                  PHONE (EVENING)

 

__________________________________________________________________________________

E-MAIL                                                                           FAX 

 

__________________________________________________________________________________

FAMILY MEMBERS I wish to include in my membership

 

I wish to become a member in the following category:

$30 Individual/Family       $60 Contributor   $100 Supporter
  $200 Sponsor   $500 Patron   $1000+ Benefactor

 

 ____My check is enclosed, payable to BSGW.

 ____I prefer to have my membership billed to:  ____Visa         ____MasterCard

     

      Account #  _______________________________          Expires_________________

 

      Signature ____________________________________________________________

 

The Society prints a membership directory listing name, address, and phone number. Would you like to be listed in the next directory?          ____Yes  ____No   

 

Please mail completed form to:

 

The Bead Museum
400 Seventh Street Northwest
Washington, DC 20004

 

Your membership dues support the Society's mission of expanding knowledge about beads.

They are fully tax deductible.

 

Thank You for Joining!