Please print this form and send it along with a check for your membership to:

            PMN/SFS
            c/o Diane Crowe
            78 Cave Hill Road
            Leverett, MA 01054

NAME ____________________________________________________________________

ORGANIZATION_____________________________________________________________

ADDRESS _________________________________________________________________

_________________________________________________________________________

HOME PHONE_______________________________________________________________

WORK PHONE_______________________________________________________________

EMAIL ADDRESS____________________________________________________________

DUES ($15-$60 sliding – scale) __________________________________________

DIRECTORY INFORMATION – Self – Description (25 words or less)

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

RESOURCES: Skills, contacts, repertoire ( check as many as appropriate)

__ Women's Music                          __ Languages other than English
__ Liberation Songs                       __ Visual Art
__ Environmental                          __ Computer
__ Fund Raising                           __ Film/Video
__ Jewish/Yiddish                         __ Humor
__ Men's Music                            __ Labor
__ Middle East                            __ Radio
__ Nueva Cancion                          __ Spiritual
__ Lesbian/Gay/Bisexual                   __ Theater
__ Photographer                           __ Anti-nuke
__ Producer/Organizer                     __ Peace
__ Black Peoples Struggle's               __ Storyteller
__ Children's Music/Stories               __ Choral
__ Engineer - Recording & Sound
__ Other (describe) _______________________________________________________

___________________________________________________________________________