MEMBERSHIP APPLICATION AND INFORMATION:
Print form with check payable to Columbus Folk Music Society, Inc. to address found below.
                                                                                                                                                Date:__________

Name:____________________________________________________________________________________

Address:__________________________________________________________________________________

Phone(Day)__________(Evening)__________E-Mail____________________ New Member  o   Renewal  o

(Membership term runs until the end of the 12th month after you join. Please check your subscription or membership level.)

Individual (1 Ballot) 15.00 o           Sponsor (2 Ballots) 100.00 o      Gold (2 Ballots)(Life) 500.00
oHousehold (2 Ballots) 25.00 o    Patron (2 Ballots) 200.00 o         Good Friend (2 Ballots) 50.00 o
Silver (2 Ballots)250.00 o          Amt. Enclosed: $______________

In order to better perform the Society’s mission of Promoting Folk or Traditional Music, Dance, Storytelling and other Folk Arts and to better serve its members, we request that you complete the following when initiating or renewing membership.
Would you rather receive the newsletter by regular mail o  e-mail (in color & interactive) o ?

Date of Birth__________ Marital Status___________ Name of Spouse______________________________

Would you classify yourself as an Instrumentalist o Singer o Songwriter o Storyteller o Dancer o
Other o If “Other” please elaborate:__________________________________________________________

If you are a performer for hire, please indicate what you do:________________________________________

________________________________________________________________________________________
Would you like to be mentioned in “FOLLOWING OUR OWN”?  Yes o  No o

Indicate any web site you or your group may have: ________________________________________________

Are you an instructor of traditional music or other folk arts?  Yes o  No o  If yes, would you like to be listed in our list of instructors? Yes  o  No o  If you are an amateur or perform for free, indicate the instruments(s) you play, what you do, etc._______________________________________________________________________
What skills or abilities do you have that you would be willing to contribute to the cause of the Society?
_________________________________________________________________________________________

Would you be willing to help organize, manage, and/or perform in a group to perform for free at Rest Homes, etc., as a community service? Yes o No o
If yes, what would you be willing and able to do?__________________________________________________
__________________________________________________________________________________________