Sierra Blues Society - Membership Application (printable online form)
use this form for change of address

Instructions:
  • fill out the information below
  • from your browsers menu select "print" and print page
  • mail the application and payment to:
    Sierra Blues Society/Membership
    P.O. Box 181
    Grass Valley, CA 95945
select all that apply:
 Individual Membership $20/year
Family Membership $30/year
"Bluzer" Lifetime Membership $300
Business Sponsor $150/year
Gift  $(enter amount)
select all that apply:
 New Member
Renewing Member
Change of Address
Keep My Address Confidential
Do Not Send Newsletter
First name:
Last name:
  Address:
  City:       State: Zip:
     Email:
     Phone: 
I would like to become a volunteer.
My skills are: 
Please list my services in the Membership Directory.
My services are:


How about some input???
What type of Blues do you like? 
Who would you like to see perform?
Where? 
My favorite charity is: 
Comments: 
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