JAVS Fall 2006

Membership Dues 0 Referred by ___________________________(print name of AV member.) 0 $48 Regular Membership 0 $53 Internationa l Membership 0 $2 1 Student Membership (Res iding outside the U.S.) 0 $58 Jo int AVS/ anadian Membership 0 30 Internationa l Student Member hip (includes bo!lt ./A VS wul VS nelllsleller) (Residing outside the U.S.) 0 $2 1 Emeritus Member hip* 0 $48 Institutional Membe rship * (those age 65-plus who have been a regular memberfor a minin111111ofR years) 0 Group Memhershir Rate (Jive or more applications submilled toge1her, 110 online reg istrwion) _ _ $42 Regul ar Membership _ _ 18 Student Membership 0 Additional Gift Membe r hip: Ha(j"price regular membership ($24 ). IIIllS/ he accompanied by your regular membership renewal. We will acknoll'ledge your ~ (fi 10 the person you lis t below: First Name Last Name -------------------- ompany ------------------------------------------- Addre. s -------------------------------- ---------- Ci t~Sw~/Zir orPo tal Code ___________ _ _ ___ _________________ ountry___________________ Home Phone____________________ Work Phone Fax ---------------------- Email ____________________ Website_____________ _ ______ _ _ AVS Local Chapter Dues: Membership in AVS local clwpters is optional and must be accompauied by membership iu the A VS National orgauizatiou. Please check all that apply. All dues sent IIIith this application payable to the A VS.

Arizona Viola Society n $ 10 Regular o $ 5 Student cnt ral TX Viola Society n $ 10 Regular o $ 5 Student Chicago Viola Society

Iowa Viola Society n $ 10 Regular o $ 5 Student Minnesota Viola Society

O regon Viola • ociety n $ 10 Regular n $ 5 Student Rocky Mt. Viollt Society n $ 15 Regular o $ 10 Student Seattle Viola Society n $ 15 Regul ar o $ 5 Student South a rolina Viola Society

Southern CA Viola Society o $ 10 Regular o $ 5 Student Utah Viola Socie ty o$ 10 Regular n $ 7 Senior rJ $ 5 Student Viola Club of DC/MD & VA

n $ 8 Regular o $ 4 Student N Viola Society o $20 Regula r o $ 10 Student Ohio Viola uciety

o 20 Regular o $ 10 Student Florida Viola Society o $ 15 Regular o $ 5 Student Idaho Viola Society

rJ $ 10 Regular rJ $ 5 Student Vir~-:inia Viola Society

o$ 10 Regular o $ 5 Student Oklahoma Viola Society

o $ 10Rcgular o $ 5 Student

o $ 10 Regular o $ 5 Student

o $ 10 Regul ar o $ 5 Student

o $ 10 Regular o $ 5 tudent

Payment Enclosed

$___ AVS Na tiona l Dues $ Chapter Dues $

I wish to make a dona tion to the Primrose Memorial Scho lar hip Fund*

$ $

I wish to make a donation to the AVS Endowment Fund*

TOTAL ( *Donations to the A VS are wx-ded llctihle as allowed by la111. ) 0 Check or money order in U.S. funds payable to the American Viola Society enclosed 0 Master ard 0 Visa 0 Ameri can Express: Credit ard #_ ____________________ Expires_____ Name on Card --------------------- Send application and payme111 10: American Viola Society 14070 Proton Rd, Sui te I00, LB 9 Dall a , Texa 75244 USA (972)233-9 107 ex l. 204 Fax (972)490-42 19

Join online at www.americanviolasociety.org!