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KENTUCKIANA BLUES SOCIETY
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| ___ | Single | - | $20.00 / year | (All Funds are US $) | Date: _______________ |
| ___ | Double | - | $25.00 / year | (2 people @ same address - 2 cards and 1 newsletter) | |
| ___ | Band | - | $30.00 / year | (1 Newsletter to 1
address - all members (up to 5) get Membership Cards) (Include Band Name and all member names) |
|
| ___ | Business | - | $150.00 / year | (1 Newsletter to 1
address - up to 5 Membership Cards, Sponsorship Listing) (Include Business Name and names for cards) |
Name(s): ______________________________________________________________
______________________________________________________________
Address: ______________________________________________________________
City, State Zip: ________________________________________________________
Phone (optional): _________________________________________________________
Email(s): _______________________________________________________________
If you are available as a volunteer to work at KBS events, please check here: ___
If you would like to volunteer your services to the Kentuckiana Blues Society, please indicate your area(s) of interest:
____________________________________________________________________
____________________________________________________________________
Printed from The Kentuckiana Blues Society Web Page @ http://kbsblues.org/
Last Revised: 31 Jul 2018