Please print out this application and mail it to the Texas Coastal Bend Bellydance Association. Mailing address available at bottom of application

 

Texas Coastal Bend Bellydance Association Membership Application

New Member_____

 Date ___________________

 Name ___________________________________ Stage Name _____________________________________           

 Address _________________________________________________________________________________

 E-Mail __________________________________________________________________________________

 Phone ______________________________________               Birthday_______________________________

Membership Category: Individual $24_____   Student  $12.00_________ 

Mailed Newsletter $6.00______________

 

   

Make checks payable to:                   Texas Coastal Bend Bellydance Association

                                                        PMB 272

                                                       1220 Airline Suite 130

                                                       Corpus Christi, Texas  78412