Piedmont Classic Guitar Society
Membership Application and
Renewal Form
Print this form,
fill it out and mail with your membership fee to:
Piedmont Classic Guitar Society, 3788 Heathrow Drive, Winston-Salem, NC 27127
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Name: |
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Address: |
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City: State: Zip: |
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Phone: |
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Email: |
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Are you interested in volunteering for the Society? (circle one) Yes No |
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Payment Info. (circle one): Cash or Check No. _____________________ |
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Member Status (circle one): New Member or Renewing Member |
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Type of Membership (Check One) |
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Student |
$7.50 |
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Individual |
$15.00 |
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Senior Citizen |
$7.50 |
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Family |
$20.00 |
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Associate * |
$25.00 |
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Sponsor * |
$50.00 |
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Patron * |
$100.00 |
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Benefactor * (lifetime) |
$250.00 |
*Amounts of $25.00 or more are tax-deductible contributions and include membership.
Note that memberships are renewed each year on January1st. If you are a new member joining after Nov. 1st,
your membership will be effective until October the following year.
Please make checks payable to: Piedmont Classic Guitar Society
Call 336-316-2376 with questions or for more information or visit our website at www.piedmontclassicguitarsociety.org