If you are renewing your membership and there are no changes, you only need to fill out this section.

Membership number: ____________    Today’s date: __________

New: ______                  Renewing: ______                    Check#/Cash________

Name: ___________________________________________________

The following is needed if this is a new membership or if there are any changes since last year.

Address:
          Street address: _________________________________________
         
City: _______________________State______ Zip +4_________
         
Phone #:_____________________________________________
         
E-mail address: ________________________________________
         
Birthday (month/day) ___________________________________________

Membership fee:  $30.00
Please make checks payable to:  Flying Geese Quilters Guild
If mailing, please send to:
         
                             Flying Geese Quilters Guild
                             PMB 292
                             14252 Culver Drive, #A
                             Irvine, CA 92604

For your information:  As a Flying Geese Quilter’s Guild member, your name will appear in the Guild’s directory, newsletter, and website.  The website newsletter and announcements will NOT LIST addresses, phone numbers, or e-mail addresses unless we have your permission.  If you do not wish your name to appear in the newsletter or on the website, please contact the newsletter editor, the website liaison, and the president of the guild in writing.
Rev: 10/05/07fs