Membership Application Select One(Required) Membership Renewal New Member Where did you hear about BRPG? Name First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone (Home)Include area codePhone (Cell)Include area codeEmail Business Website (If Applicable) Optional Website ProfileDo you want to be listed on the directory? Yes. Requires a $20 payment No For the public directory on the website, list the following info you would like to share. Name on Directory Listing Email on Directory Listing Committee(s) you’d be willing to serve on Finance Programs Scholarships Student Show Nominating Publicity Hospitality Outreach Social Media iContact Website By signing below, I agree to the following Guild requirements: Pay annual dues of $30, included with this application. Dues are not prorated for a partial year. Voluntarily donate 1 or more bowls or comparable pieces to each of the 2 guild-supported Empty Bowl events: Ferrum Empty Bowls and Smith Mountain Lake Empty Bowls. Agree that my information above will be made available on the “Members Only” page of the BRPG website, not the public page. SignatureSkills you’d like to share with othersSkills you’d like to learnSuggestions for guild activitiesSuggestions for WorkshopsDo you plan to take part in the annual show?(Required) Yes No Total Amount Due How would you like to pay?(Required) Pay with Credit Card Mail a Check Credit Card(Required) Cardholder Name Card Details Please make the check out to: Blue Ridge Potters Guild In the note of the check please write in the name you entered in the Name fields above. Mailing address: Joanne Snyder, 1151 Dalton Point Road, Moneta, VA 24121Check Number CAPTCHA
