MEMBERSHIP APPLICATION
FORM

YES, I WANT TO BECOME A MEMBER ___
YES, | WANT TO RENEW MY MEMBERSHIP ___

I/We are applying for the following category of membership:

Individual $35
Senior $20
Family or Studio (2/4 persona) = __
Institution/Group a
Full time Student $20
NAME:
ADDRESS: |
POSTAL CODE:

PHONE:
I/We enclose $ cash, cheque or money order.
MAIL TO: POTTERS GUILD OF B.C,

1359 CARTWRIGHT ST.

VANCOUVER, B.C.

Va0o 5G8

MERRY CHRISTMAS
AND HAPPY NEW YEAR