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NFDI Membership Application Form

Please send this form with your payment to the address at the bottom of the form.
Name(s):  
Address:   
City:      State      9-digit ZIP:
E-mail:     Phone number:
Birthdate (Junior members only):     Club Affiliation:
This membership is: (Circle one)      New      Renewal
Deliver the newsletter via: (Circle one)      Mail      Email

Membership type (check one):
( ) Club membership$25.00
( ) Adult member (18 & over)$20.00
( ) Jr. members (17 & under)$10.00
( ) Household (2 adults/same address) $25.00
( ) Family (1 or 2 adults + children) $25.00
( ) Gold card members (postage only)$ 5.00
  Gold cards are awarded by the NFDI board only
( ) Foreign countries (including Canada)
Subscribers who agree to receive the newsletter via email pay U.S. rates
$35.00
  
Subscriptions may be paid for multiple years at one time.
Please indicate for how many years you are subscribing.           ______________
( ) Donation to NFDI - General Fund (May be tax deductible)                $______________
( ) Donation to the NFDI Youth Fund (May be tax deductible)                $______________
  Total enclosed  $______________
( ) Gift subscription: From _______________________________________
 
I understand that $15 of my membership fee applies to a subscription to THE NORTHWEST FOLKDANCER magazine.
Signature:    (required)
All Canadian and foreign cheques must be payable in U.S. funds. Memberships are valid for one year from the date you join. Make checks payable to NFDI.
  
Mail completed applications with payment to:
Northwest Folkdancer, Inc., c/o Linda Caspermeyer, 8415 - 5th Avenue NE, #205, Seattle, WA 98115-4165