Please print out this application and mail it to the Austin Bellydance Association. The address is printed on the bottom of the page.
AUSTIN BELLYDANCE ASSOCIATION MEMBERSHIP APPLICATION
New Member_____ Renewal_____ Address Change_____
Date ___________________
Name ___________________________________ Stage Name _____________________________________
Address _________________________________________________________________________________
E-Mail _____________________________________________________
Phone ______________________________________ Birthday_______________________________
Membership Category: Individual $20 _____ (Add $5 per additional adult member of household requesting Membership Card.)
List Additional Household Members:___________________________________________________________________________________
Business $25 _____
Make checks payable to: Austin
Bellydance Association
P.O. Box 141054
Austin, TX
78714-1054