SHASTA BLUES SOCIETY
MEMBERSHIP APPLICATION

Application Date: ________________

New Application [__]   Renewal [__]   Member Card#: _____________  Exp. Date _______

Address: ________________________________________ City / State / Zip _____________________

Phone # - ( home) _________________work) ___________ E-mail address ______________________

Instrument(s) Played __________________________________________________________________

Level:      Beginner [__]     Intermediate [__]      Advanced [__]

Membership Fees: (Single or Family Price)

Students $5 / 1 year [__]  Regular Member $20 / 1 year  [__]   $100 Business  / 1 year [__]
(6 ads, plus 6 tickets for membership bash for Business Membership)

Make checks payable to: Shasta Blues Society
Mail to: PO Box 994693, Redding, Ca. 96099-4693    Attn: Membership 

-------------------------------------------------------------------------------------------------------------------------------------------
(cut along dotted line)

Weekly Jam Sessions .... 6  Bi-Monthly Newsletters .... Discounts on SBS Apparel .... Music Workshops.... Discounts on all SBS Sponsored Events....Annual Membership Bash

10% Discount at Local Music Stores:

Herried Music 243-7283    Bernie's Guitar, Inc.  223-2040
Music Max 547-7070
(Does not include sale or consignment items)