JAVS Fall 2007

Membership Dues

D Referred by------------------=:---------(print name of AVS member.) D $48 Regular Member hip D $58 International Membership D $21 Student Membership (Residing outside the U.S.) D $63 Joint AVS/Canadian Membership D $30 International Student Membership D (includes both JA VS and CVS newsleuer) (Residing outside the U.S.) D $27 Emeritus Membership* D $48 Institutional Membership • (those age 65-plus who have been a regular memberfor a minimum of8 years) D D Group Member hip Rates (fi1•e or more applications submitted together, no online registration) __$42 Regular Member hip __ $ 18 Student Membership D Additional Gift Membership: Halfprice regular membership ($24), must be accompanied by your regular membership renewal. We will acknowledge your gift to the person you list below: FirstName LastName ____________________ Company ----------------------------------------- Addres__________________________________________ Ci~~~tdZipmPos~ I Code ________________________________ Country___________________ Home Phone ___________________ VVorkPhone Fax ~-------------------- Email __________________ \Website -------------------- AVS Local Chapter Dues: Membership in AVS local chapters is optional and must be accompa11ied by membership i11 the A VS Natio11al orga~tizatiolt. Please check all that appZI'. All dues sent with this application payable to the AVS.

Iowa Viola ociety

Oregon Viola ociety D $ 10 Regular D $ 5 Student RocktJMt. Viola ocier:y $15 Regular D S 10 Student ea ttle Viola ociety D $ 15 Regular D S 5 Student outb Car olina Viola ociety

outhero CA iota ociety D $1 0 Regular D $ 5 Student Uta h Viola Society D $ 10 Regular D $ 7 Semor D S 5 Student Viola C lub of DC/MD & VA

Ar izona iota ociety D $ 10 Regular D $ 5 Student

D SIO Regul ar

D

5 Student Central TX Viola ociety Minnesota Viola ociety D $ 10 Regular D $ 8 Regular D $ 5 Student D 4 Student Florida Viola ociety NC Viola ociet)• D $15 Regular D S20 Regular D $ 5 Student D 10 Student F lorida iota ociety Ohio iota ociety 0 $15 Regular 0 $ 10 Regular D $ 5 Student D $ 5 Student G reat Lakes iota ociety Okla homa iota ocier:y D $20 Regular D 10 Regular D $ 10 Student D 5 Student

D $ 10 Regular D $ 5 Student Virginia Viola Society

Ll $10 Regular D $ 5 Student

D $10 Regular D $ 5 Student

Payment Enclosed

AVS National Dues

$ $

Chapter Dues

$ I wish to make an unrestricted gift to the AVS in honor or memory of________________• $ I wi h to make a donation to the Primrose Memorial Scholarship Fund* $ I wish to make a donation to the AVS Endowment Fund* S I wish to make a donation to the David Dalton Viola Re earch Competition• ___ Please send me more information abow donating an instrument to the AVS Viola Bank* $ TOTAL (*Donations to the A VS are tax-deductible as allowed by law.) D Check or money order in U.S. funds payable to the American Viola Socie~ enclo ed D Ma terCard D Vi a D American Expres : Credit Card #-:---------------------- Expires____ NameonCMd ___________________

Send application andpayment to: American Viola Society • 14070 Proton Rd, Suite 100, LB 9 • Dallas, Texas 75244 U A (972)233-91 07 ext. 204 Fax (972)490-42 19 Join online at www.americanviolasociety.org!

Revised I011512007