The Los Angeles Guild of Puppetry
Membership Application and Change Form
Please check as many boxes as needed.  (If completing online, use tab key to jump from line to line, space bar for check marks and do not hit enter.)
C= Change
A= Add
OD=Omit from On-line Directory
OP= Omit from Published directory
Applying for New Membership  
Existing MemberChanges and / or Renewal
NAME (required)  C A OD OP
COMPANY C A OD OP
ADDRESS (required)  C A OD OP
CITY (required)    C A OD OP
STATE (required)  C A OD OP
 ZIP (required)   C A OD OP
PHONE
Home C A OD OP 
Cell C A OD OP
E-mail C A OD OP
Web Site C A OD OP 
What are your interests in puppetry?
Builder
 Collector
 Educator
 Enthusiast
 Performer
 Other

Please check the box if you are a member of:
Puppeteers of America
 UNIMA
 SAG
 AFTRA
 AEA
 AGVA
Present or past officer of any puppetry guilds?
(Guild Name, Office Held, Current/Past)
 


Festival Scholarship Fund
This fund provides financial assistance for a Guild member to attend the next National Puppetry Festival.  The LAGOP thanks you for any contribution!
Yes, I wish to give a gift.
NEW JUNIOR MEMBER (7-18 yrs / Newsletter, Guild Pin) .................................................... $20
NEW SENIOR MEMBER (65 and older / Newsletter, Guild Pin, 1 Vote) ................................ $25
NEW ADULT MEMBER   (Newsletter, Guild Pin, 1 Vote) .......................................................$30
NEW FAMILY/GROUP (2-4 Members @ Same Address / Newsletter, Guild Pin, 1 Vote) ....... $40
NEW BUSINESS MEMBER (Newsletter, Guild Pin, 1 Vote, Sponsor Recognition) ............... $60
SUBSCRIPTION TO NEWSLETTER ONLY (no Vote) ............................................................ $20
ADDITIONAL GUILD PINS ARE AVAILABLE FOR ........................................................ $10 Each
INT'L POSTAGE (required for newsletters sent outside the U.S.) ......................................... $15

Our annual membership year is July 1st through June 30th. Sorry, we do not prorate; however, joining after April 30th will extend membership through June 30th of the following year.
I enclose $ for dues, $15 for international postage (if applicable), and a gift (optional) of $ for the Festival Scholarship Fund.

The total enclosed is: $
Print and mail with check or money order payable to:
Los Angeles Guild Of Puppetry c/o
Pat Brymer
136 North Avenue 61, #102
Los Angeles, CA 90042

Attention New and Renewing Members
 
At this time, there is no pay on-line feature. You must print this form and mail it with a check to the address above.
If you are an existing member and are using this form to make changes to your information in the directory, you may submit this form electronically by clicking the submit button below.

Members making changes 

Copyright © 2001-2011 [Los Angeles Guild of Puppetry]. All rights reserved.
Revised: September 11, 2011