CMSPCG Membership Application

June 2014- May 2015 Membership Form

Full Name (please print): ______________________________________________________________

Street Address: _____________________________________________________________________

City: _______________________________ State: ______________________ Zip:_______________

Home Phone: ____________________________ Cell Phone: ________________________________

Email Address (please make this legible): __________________________________________________

Birthday (month and day only) __________________________________________________________

Membership Directory (Check all that apply) CMSPCG may publish a membership directory for distribution to members only. Please specify what information you want included:

___Name ___Address ___Phone # ___Email ___Do NOT publish my information

Volunteer Information (check all that apply) Please let us know if you would like to help in any of the following areas.

____Conduct a clay demo during a meeting

____Help with Workshops ____Happy Bags ____Pot Luck Lunch _____ Ovens ____teacher gift

____Other: ________________________________________________________________________

Serve on the Executive Board as:

____President ____Vice President ____Treasurer ____Secretary ____Webmaster ____

Membership Information: $20 Yearly make check payable to: CMSPCG

New: ____________ Renewing: _________________

Signature: _________________________________________________________________________