Membership Form

South Shore Folk Music Club
P.O. Box 156
Kingston, MA 02364-9998
781-871-1052
www.ssfmc.org (a non-profit organization)

New Member/Friend ____ Renewal ____

Name _____________________________________

Date ___________

Address _________________________________

City _______________State _____ Zip ___________

E-mail ___________________

** I wish to receive the Hurdy Gurdy via E-mail regular mail
* I'm not ready to become a member but wish to receive the Hurdy Gurdy via regular mail
*e-Friends receive the Hurdy Gurdy via E-mail .

Membership Term: September 1 through August 31.

Discounts: Current "Regular Members" may deduct .70 cents for each month from the cost of membership renewal if your membership expires between September 2003 and February 2004. Renewals for "Member and Guest" level can deduct $1.00 for each of those months. You may, of course, upgrade your membership level. See the Membership Changes page for a more detailed explanation.

Please mail this application via regular mail to the address above with self-addressed, stamped envelope.

SSFMC USE ONLY

CARD NUMBER ____________________
EXPIRATION DATE ________