Membership Application
www.crossroadsbluessociety.com
Print and mail this or click here: http://www.crossroadsbluessociety.com/membership.htm
Yes! I’d love to be a part of the Crossroads Blues Society!
Name________________________________________ Phone___________________________
Street Address__________________________________
City________________________ State___________ Zip Code___________
Email Address_________________________ New_____ -or- Returning_____ Member
This will be a membership for an: _____individual ($15) _____family ($25)
Please cut out and mail this form and payment to: Find out about the next meeting date &
Crossroads Blues Society bring this along with you!
P.O. Box 722
Freeport, IL 61032
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