Arkansas Valley Music and Dance 2016 Membership Form
1. Satisfaction that you are supporting a valuable organization
2. Discounts at AVMAD Salida contra dances
3. Name & hotlink on on Members page
4. A limited number of your events listed on online calendar at and our Facebook page

Membership is $24/year (Jan - Dec) for individuals, households, businesses, and organizations alike.
Your Information
This will not be shared with other organizations.
First & Last Name(s) *
Please include names for each person in your household. EACH NAME SHOULD BE ON A SEPARATE LINE.
Email Address(s) *
Please include email addresses for each person in your household who has one. EACH ADDRESS SHOULD BE ON A SEPARATE LINE.
Phone Number *
Please include numbers for each person in your household. EACH NAME & PHONE NUMBER SHOULD BE ON A SEPARATE LINE. Format: John xxx-xxx-xxxx
Organization / Business Name
If applicable.
Organization / Business Website
If applicable.
Mailing Address
Personal or Business - whichever is better
City *
State *
Abbreviation Only
Zip Code
Information for AVMAD
How should we list you on our website? *
Check any of the following ways you would be interested in helping:
Our organization relies on volunteers. Once we know your interests, we'll contact you to discuss possibilities. Checking a box does not imply commitment.
Anything else?
Anything else you want to tell the AVMAD membership coordinator?
How will you be paying for your membership? *
Payment Notes
Is there anything you want to tell us about your payment?
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