Connecticut Piecemakers Quilt Guild Registration Form

2009-2010

 

 

NAME_________________________________________________

(Please Print Clearly)

ADDRESS______________________________________________

CITY_____________________ STATE________ ZIP___________

PHONE___________________

BIRTHDAY (no year needed)__________

E-MAIL ADDRESS____________________________

___Please check here if you are renewing your membership and any of the above information has changed

        ___Renewal $30.00

        ___New Membership $30.00

      **PLEASE SEND ONLY CHECKS, MADE PAYABLE TO:

“Connecticut Piecemakers Quilt Guild”

PLEASE RETURN THIS FORM & PAYMENT TO:

Wendy Frieden

CT Piecemakers Quilt Guild, Membership Chairman

15 Coachman Lane

Bethany, CT  06524