Dues: $10.00 newsletter only $15.00 Single - $20.00 Couple (USD annually)

Date_______________________

Performing Member___ Supporting Member___  New membership ____   Renewal _____

 Instruments______________________________________ ________________________________________________
___Vocalist ___Band Leader

NAME(s)_________________________________________

 ADDRESS________________________________________

 CITY________________________STATE___ZIP________

 PHONE_________________E-MAIL__________________

BIRTHDAY_____________________(MONTH/DAY)

MALE/FEMALE__________________

ANNIVERSARY__________________

 SIGNATURE______________________________________

 REFERRED By____________________________________

 Check # ___________ Money Order__________

Western Swing Society Approval______________________

COPY AND PRINT APPLICATION
MAIL TO:    (WITH CHECK)
NWWSMS
P.O. BOX 14003
MILL CREEK, WA  98082