PBS Membership Application

Membership Application

Please note: The Family membership includes your entire household - yourself, your spouse, children, or 'significant other'.

Please select status of application: New Member Current Member Renewal

Please select type of membership: $ 20 Family $ 20 Business

First Name:

Last Name:

Business or Organization Name:

If you have a business, would you be interested in sponsoring our website and/or advertising in our newsletter?
Yes No Not at this time

Street or Mailing Address:	City:	State:

Province/Country: (if not U.S.)	Zip/Postal Code:	Telephone: (include area code, please)

If you have a bead related website, please include the URL here:

E-mail address:

Would you like to actively participate as a volunteer or staff? Yes No

Please include any comments or requests:

When you click the submit button, a page will come up with your membership application information for you to print out. Just send it along with your check or money order to:

Portland Bead Society
Membership Secretary
P.O. Box 997
Portland, OR 97207-0997

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