P. O. Box 4064
Lynchburg, VA 24502-0064
Tele. (434)
237-8080
Website:
www.jamesriverblues.org
E-Mail:
jamrivblusoc@aol.com
MEMBERSHIP
APPLICATION
The James River Blues Society is a
501(c)(3), non-profit, tax exempt, all volunteer organization dedicated to
promoting and preserving blues music in the central and western areas of
Virginia. Individual, Family, or
Blues Buddy membership entitles you to the following: membership ID, e-mail alerts, discounted
admission to JRBS sponsored events where applicable, and discounts from selected
merchants. Sponsor membership
entitles you to membership ID, e-mail alerts, and free business card size ads on
our website.
MEMBERSHIP IN THE SOCIETY IS FOR A
PERIOD OF ONE YEAR
q NEW MEMBERSHIP
q RENEWAL
q
Individual
[$10.00]
q
Blues Buddy «
[$25.00]
q
Family
[$15.00]
q
Sponsorship
[$100.00] minimum
Please inquire regarding overseas
rates.
« Blues Buddy membership includes
one free JRBS t-shirt. è State t-shirt size: L XL 2X
3X
q
CHECK HERE IF YOU WOULD LIKE YOUR
T-SHIRT MAILED. YOU MUST INCLUDE
AN ADDITIONAL $4.00 FOR
SHIPPING AND
HANDLING.
Please
return this membership application with a check or money order made payable to
the James River Blues Society.
Thank you!
PLEASE PRINT OR
TYPE
NAME |
ADDRESS |
CITY
STATE
ZIP |
TELEPHONE (Home)
(Work) |
E-MAIL ADDRESS (To receive
JRBS e-mails) |
OCCUPATION
(Optional) |
q
Check here if you do not wish for
your name and address or e-mail address to be distributed to other organizations
that promote the blues.
REV.
9/2004