Membership Form 

Contact Information
New Membership Renewal Gift Membership
: USA Canada Other
Postal Code/Zip Code:
Phone:
Email Address:
Website:
Gift From:
Referred By:
Membership Level
Student $55
  (Send copy of current Student ID card)
Senior (age 65 and over) $55
Friend $65
Associate $110
Guild/Organization $110
Benefactor $250 - $999
Sponsor $1000 - $1999
Patron $2000 - $4999
Pacesetter $5000 - $9999
Master's Circle $10,000 and above
  If you chose Benefactor, Sponsor, Patron, Pacesetter or Master's Circle, please enter the amount of your membership below. Only enter numbers. No dollar signs ($) or commas.
  Amount: $
  Extra postage for international members:
  • Canada: please add $5 for postage. 
  • All other countries please add $18 for postage
To Make a Donation
Fund Amount
  Type only numbers and decimal points into the boxes.
Dime a Day $
Endowment Fund $
Cuesta Benberry Keynote Fund $
Lucy Hilty Research Fund $
Publications Fund $
Seminar Scholarship Fund $
Unrestricted Donation $

How to Receive Publications

Blanket Statements is sent to members by e-mail unless you choose to receive a paper version by mail.

I would like to receive my Blanket Statements via mail Yes No

I would like to receive my February Directory via mail Yes No

Quilt-Related Interests

The following information will be listed with your name in the Directory. Please check all that apply.

Appraiser Historian
Author Industry
Collector Museum
Dealer Quilt Maker
Designer Quilt Restoration/ Conservation
Educator Research
Folklorist Women's Studies
Other
If "Other" was selected, please indicate what your interest is: