Member Application | Naples Quilters Guild

Member Year

Year Joined

Application

*INDICATES REQUIRED INFORMATION

First Name *

Last Name *

Email Address *

This will be your login user name

Password *

Please enter a password (up to 10 characters).

Confirm Password *

Confirm Password

Birthday
Month

Birthday
Day

Dates in
Florida

(e,g, Year Round, Jan-Apr, etc.)

Contact Information

Local Street Address

Local City

Local State

Local Zip Code

Home Phone Number

Cell Phone Number

Alternate Contact Information

If you have an alternate address, please check the box below.

I have an alternate address

Alternate Street Address

Alternate City

Alternate State/Province

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Interests:

I would like to learn how to:

Nationally known or local quilters I would like to hear include:

Workshops I would like to attend (list subject, idea or interest):

Please check office, committee or guild activity where you may be willing to help:

Check All That Apply

Special Skills/Areas of Expertise

Computer

Artwork

Photography

OtherOther

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Last

Phone

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