Baltimore Appliqué Society Home

Membership Form

Name:
Address:
Phone:
E-mail address:

Please send newsletters via:	E-mail	U.S. Mail
May we publish your address, phone number and e-mail address in the BAS membership directory?	Yes	No
Are you a member of:	AQS	NQA
Is this membership:	New	Renewal
The membership period runs from Sept. 1 through Aug. 31.
Dues: Full Year	$20	($25 foreign)
Prorated: Feb. 1 to May 31	$10	($12.50 foreign)

Checks must be in US funds, made payable to BAS.
Please mail this completed form with your payment to: