Chicagoland Puppetry Guild
Membership Application

Continuing and New Members Please Copy/Paste, complete form
Mail with your check or money order
(payable to The Chicagoland Puppetry Guild)
to CPG Treasurer, Yvonne Yosseif
5056 N. Lockwood #2, Chicago, IL 60630-2267

CPG DUES:

______Single Adult__________________$20.00/yr
______Couple______________________$30.00/yr
______Junior (under 18)______________$15.00/yr
______Associate___________________ $15.00/yr (Recieves Puppet Patter/Cannot Vote
______Corporate____________________$20.00/yr (One vote)

Check type of membership(s) TOTAL AMOUNT ENCLOSED $_______

NAME:_______________________________________________

ADDRESS:______________________________________________

CITY:___________________________STATE____________ZIP____________

PHONE NUMBER:______________E-MAIL: _____________ FAX:_____________

I prefer to be contacted by: Phone___ E-Mail___ "Snail" Mail___ Fax___

PLEASE NOTE! A new edition of the Membership Direcory is published and distributed among the membership during November. If you do not wish to be listed, please indicate below. If you do wish to have your name added to this Directory and would like to add information such as daytime phone #, or if you have another way you'd like your information to appear in the Directory, indicate so on the form below, making any necessary changes.

____YES! Please add my name to the upcoing Directory and note the following changes in my information:

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

____NO! Do not add my name and information to the Directory.

Your Guild and its members are interested in you! Please tell us about your interests in puppetry, what you are doing and your status as a puppeteer:

_______Professional _______ Marionettes

_______Semi-professional _______ Hand puppets

_______Hobbyist _______ Shadow puppets

_______Librarian _______ Rod puppets

_______Teacher _______ Ventriloquist

_______Other__________________________________________

At times, the Guild is asked for sources of puppet shows, workshops, etc. IF you are interested in being recommended, please state what you are capable of doing and any performance limitations that you may require.

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

Are you a member of the national organization, The Puppeteers of America?_______
Are you a member uf UNIMA or UNIMA USA?______
Are you a member of any other puppetry related organization?______

Would you like information about joinging the P of A or UNIMA USA?______

Are there any CPG Committees of which you would like to be a member?______

If so, which Commitee?______________________________________

DATE TODAY________________(for applicant)

DATE RECEIVED_______________(treasurer)