Applications



KENTUCKY FRIENDS OF BLUEGRASS MUSIC CLUB, INC.

303-A BLUEGRASS LANE, CLAY CITY, KY. 40312-9588

PHONE: 606-663-9008 email: kyfriends.us
APPLICATION FOR MEMBERSHIP

MEMBERSHIP FEES PER YEAR: SINGLE $12.00; COUPLES $18.00;


STUDENTS $(15 TO 18) $5.00; BANDS $25.00



NAME:_______________________________________________ 
BIRTHDAY MONTH:_________________

ADDRESS:____________________________________________ 

FOR COUPLES ONLY:________________

CITY, STATE:_________________________________________ 

SPOUSE NAME:______________________

ZIP CODE:____________________________________________ 


SPOUSE BIRTHDAY MONTH__________

TELEPHONE:_________________________________________ 

ANNIVERSARY MONTH:_____________

EMAIL:_______________________________________________

MEMBERSHIP TYPE: 

SINGLE_____COUPLE_____STUDENT_____BAND_____NEW_____RENEW_____

PAID BY: 

CASH________CHECK #__________OTHER_______________

MEMBERSHIP INFO:


MUSICIAN________PLAY INSTRUMENT_______FAN_______PROMOTER_________

DATE:_____________     
RECEIVED BY:________________________


AMOUNT:$____________CARD:____________COMPUTER_____________



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