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Membership Type

Single ($30 / year)_________ Two Adults ($40 / year)

Student ($25 / year; requires Student I.D.)

Lifetime, Single ($400)

Lifetime, Family ($500)

International Membership Surcharge ($10)

Membership Information

Member Name:
Street Address:

E-Mail Address: (required)
Are you renewing Membership?_ Yes ___ No

Instruments you play:
Are you in a band?_ Yes ___ No

Co-Member Information

Member Name:
Street Address:
City, State, Zip
E-Mail Address:
Instruments you play:
Are you in a band? Yes ____ No

Volunteer Interests

Activities Committee _____ Blues in the Schools
Archives Committee ____-_ Festival Committee
Website Committee ______ Concessions
Publicity Committee ___-__ Wherever Needed


Are you willing to be called by phone?__ Yes __ No

Referred by:


Blues Foundation


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