PSWA Member Registration Form

PSWA MEMBERSHIP REGISTRATION FORM

Please register me as a member of the
Pacific Southwest Wildlife Arts

Name:

______________________________________

E-Mail Address:

______________________________________

Mailing Address:

______________________________________

______________________________________

______________________________________

______________________________________

Please circle your interest from the list below:

Carver

Artist
Colector

Please fill out this form and mail it along with $20.00 to:

Karen Geuy, PSWA Membership
40461 Rock Mountain Road
Fallbrook, CA 92028
Phone 760 723-9800