Membership Application
For a PDF version of this form click here
Please print this form and keep a copy for you records. Complete and sign the form and send it to the address below with your membership fee.
The Annual fee is $36.00 and provides membership from June 1, 2008 through May 31, 2009.
Please make your check or money order payable to: American Glass Guild.
To pay by credit card (Master Card or Visa ONLY)
Credit card number:_________________________________________
Expiration date:___________________________
Name as it appears on card:___________________________________________________
Security code (three digit number on back of card):_________________
Billing address for credit card:_______________________________________________
________________________________________________
__________________________________________________
Amount to be charged: $36.
Signature:________________________________
Please FAX this form to 781-449-0821 (no cover page necessary)
OR
Mail your check and this form to:
American Glass Guild
c/o Membership Chair
21 Highland Circle
Needham, MA 02494
Name:_______________________________________________________
Studio or Business Name:________________________________________
Street Address:_____________________________________ Apt#: _____
City:________________________________________________________
State/Province:______________ Country: ___________ ZIP:__________
Email (Required):_______________________________________________
Phone:____________________ Fax: ______________________________
Your signature on this application is authorization for the American Glass Guild (herein AGG) to do the following: 1. send you emails regarding issues or events that are sponsored, supported or endorsed by the AGG; 2. add your name to our list of members on our website.
If you DO NOT want to receive emails from the AGG, initial here _______
If you DO NOT want your name on the AGG website, Initial here _______
Further, by signing below, you agree to support the mission of the AGG, its rules, and code of ethics.
______________________________________ _____________________
Signature Date
_________________________________________________________
Print Your Name Here
For a PDF version of this form click here