CPG DUES:
______Single Adult______________$20.00/yr
______Senior (62+)_____________$15.00/yr
______Student_______________ __$15.00/yr
______Couple/Family_________ __$30.00/yr
______Junior (under 15)_________$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.
CPG members are interested in you! Please tell us about your interests in puppetry, what you're 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?______________________________________

APPLICANT      DATE TODAY________________ 
TREASURER     DATE RECEIVED_______________