GOOD HOPE QUILTERS' GUILD  - Application for Membership

(Please PRINT)

Name……………………………………………………………………. Date of Birth …………………………….

Address……………………………………………………………………………………………………..

…………………………………………………………………………………………………Code……………………….

Tel……………………………………………….Fax……………………………………..Cell…………………………..

Email……………………………………………………………………………….

Please Indicate – I want to receive newsletters by post …......... or by email……..…..

I am happy to receive information from time to time about quilt related matters by email.     Yes......…. No….....

Signed ........................................................................................................................   Date ................................................

R120  payable to:   Good Hope Quilters’ Guild, PO Box 584, Howard Place, 7450

Direct Deposit

Standard Bank - Pinelands  - Account no 073027405  - Branch code 036309

NB! Fax copy of payment with your name and details attached to Tel + 021 887 1780