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:     Club Affiliation:
Circle one:  New   Renewal

Membership type (check one):
( )	Club membership	$18.00
( )	Adult member (18 & over)	$16.00
( )	Jr. members (17 & under)	$ 11.00
( )	Household (2 adults/same address)	$20.00
( )	Family (1 or 2 adults + children)	$20.00
( )	Gold card members (postage only)	$ 5.00
	Gold cards are awarded by the NFDI board only
( )	Foreign countries (except Canada)	$35.00

Subscriptions may be paid for multiple years at one time.

Please indicate for how many years you are subscribing.     ______________

( )	Additional donations to NFDI (tax deductible)                $______________
	Total enclosed  $______________
( )	Gift subscription: From _______________________________________
( )	Electronic newsletter preferred

I understand that $10 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. Please include a self-addressed, stamped envelope so that we can mail your membership card(s). 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