Houston Embroiderers' Guild
Membership Form for New Members and Corrections
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Name:_____________________________Birthday(mo/day)_____________
Spouse's Name:_____________________________________
Address:___________________________________________
City:_______________________________State:___________Zip:________
Phone:(home):___________________________(work)__________________
(cell):____________________________(fax):___________________
E-Mail:_________________________________________________________
These amounts are good only for new members. If you are renewing late, the
amounts are in ().
Primary Membership in HEG, $71.25 ($57.00)
Plural Membership within South Central Region, $18.75($15.00)
Plural Membership outside South Central Region, $25.00 ($20.00)
Life Member in HEG, $25.00 ($20.00)
If you are a plural member, please give your
Primary Chapter:__________________________________
and membership number:_________________________
Make checks payable to Houston Embroiderers' Guild:
Mail to : Membership HEG
C/O Joanna Baleson
2128 Willowdell Dr.
Seabrook, TX 77586
Form good through April 30, 2012
All dues are good through May 31, 2013