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 303531
                                                                Austin, TX 78703