Membership Application Form

Membership w/ Kenai Performers

Membership runs JANUARY 1st through DECEMBER 21st.
Name

First NameLast Name
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
example@example.com
Home Number
Format: (000) 000-0000.
Alternate Number
Format: (000) 000-0000.
Signature
Signature Date

MonthDayYear
Date

Individual

$25.00

Family

2 or more in same household

$50.00

Lifetime

$400.00

Total

Membership w/ Kenai Performers