PIECEMAKERS OF ELMIRA
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To print this page, you must copy and paste into a word processing program.  You can also make one out at our monthly meeting.
                                        Membership Application Form
​                                         Membership Year 2022 - 2023

 
Name:                                                                           Phone:                               
Address:                                                                      City:                                   
State:                                                                            Zip:                                   
Winter Address:                                                                                                                        
Dates @ Winter address       From:                                            To:                                      
E-Mail:                                                                                         
I would like to receive my newsletter e-mail                  or regular mail             
 
Month and Day of Birth:                                                            
 
I will serve on the hospitality committee for the month of                                                
This task is to coordinate the refreshments for our social hour prior to meeting and to clean up after meeting.
 
I would be interested in sharing my talents or skills with a demonstration and/or instruction at our meeting about                                                                                           
This could be extended to a workshop on the subject after lunch.
 
I would be interested  in serving on the Board (list position)                                             
I would be interested in serving on an existing committee                                                 
 
Membership fee is: $20.00/year
Make checks payable to:        Piecemakers of Elmira
 
Payment:
Check Number                            Cash                                        Date:                  
 
Received  by Marcy Coggins      on:                                                        
 
Given to Treasurer:                Initials:                                         Date:                  
 
Revised:  June 1, 2018                                                                   Card: