APPLICATION FOR MEMBERSHIP

“THE CARAVAN”               The Official Fan Club of Peter White

 

Name: ________________________________________________________________________

 

Address: _____________________________________________________________________

 

City: ___________________________ State/Zip______________ Country_____________

 

Phone Contact: _________________________ E-Mail Address: _____________________

 

Your Birthday: _________________________

 

Tell Us About you:  (hobbies, career, children, whatever you like)

 

 _____________________________________________________________________________

 

 _____________________________________________________________________________

 

Favorite Peter White Album: __________________________________________________

 

Favorite Peter White Song: ___________________________________________________

 

Other Jazz Artists You Follow: _______________________________________________

 

What part of the Fan Club would you like to contribute to if you can?

(Check as many as you want, but I’ll be calling on you):

 

 __Graphics/Design                          __Photos  

    

 Newsletter Contributions

    __Reviews                             __Editorials/Opinions

    __Keeping up with other artists       __Contest Suggestions

    __PW Crossword Puzzle                 __Fan Club Get-togethers

    __Membership drives

    __Musicians Corner (comments or technical points, reviews, critiques, opinions)

 

    __Any other (your suggestions are always welcomed)_______________________

 

      _________________________________________________________________________

 

$20.00 USA & Canada

$25.00 for International

 

Official E-Mail Address:      PerfectCaravan@aol.com

 

Check or Money Order payable to:    The Caravan c/o Joan Lynch

 

Mail to:   Vicki Rea

           10313 Green Links Drive

           Tampa, Florida 33626   USA

 

Your annual membership will include quarterly newsletters and the opportunities to participate in give-aways, meets and greets (if possible), contests and raffles.

 

 

Member’s Signature ____________________________________________________________

 

New __   Renewal __

 

Referred by ________________________________________________________________

 

 

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