SAN FRANCISCO CERAMIC CIRCLE ON LINE MEMBERSHIP APPLICATION

Please use your browser print function to print this form

Membership category selected:

Individual $60.00 [ ... ] , Dual ( 2 persons at the same address ) $95.00 [ ... ]. Please check one

Check # ...................... enclosed herewith for $........................... Dated ............................................

Please print clearly

Member name (First / M.I. / Last) .........................................................................................................

Dual member name (if applicable-First / M.I. / Last) ...........................................................................

Address ( Street ) .................................................................................................................................

( City / State / Zip ) ..............................................................................................................................

Phone number (.................) .............................................

Fax number (................) ..................................................

Email address .....................................................................................................................................

I would prefer to receive SFCC communications by mail [ .... ] email [ ... ]. Please check one.

Mail your application to:

San Francisco Ceramic Circle

P.O. Box 15163, San Francisco, CA 94115

Welcome to the SFCC. Please introduce yourself at the first meeting you attend.

Please use the reverse side of this form to let the SFCC know of any special areas

of ceramic interest you may have and if you have ( or are interested in forming )

a ceramic collection