Klamath Blues Society (KBS) Membership Application

New Application   Renewal

Name:_______________________Spouse or Couples Name:_____________________

Mailing Address:_________________________________________________________

City/State/Zip:___________________________________________________________

Phone: Home:________________________Cell________________________________

Instrument(s) played:_____________________________________________________

Level of playing: Beginner ( ) Intermediate ( ) Advanced ( )

E-mail address:__________________________________________________________

Member Fees (one year): Singles: $20.00   Couples: $30.00 :   Bands: $35.00

Business Sponsorship: $100.00

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Klamath Blues Society: PO Box 7926 Klamath Falls, OR. 97602

Contact: WWW.KLAMATHBLUES.ORG ---or---- klamathbluesnews@gmail.com