Great Lakes Blues Society

Membership Form

The Great Lakes Blues Society serves as a strong, active voice in the London Region to perpetuate the Blues. Please join us, and be part of an organization to help take the Blues into the 21^st Century in our Community. We need your participation to make it work. It can and it will!

You can choose to either download/print/mail your membership form by clicking here or complete the form below to pay online.

Membership Type:

First Name:

Last Name:

Second Name (Family Membership *Only*):

Second Email (Family Membership *Only*):

Second Phone (Family Membership *Only*):

Band Name (Musician Membership *Only*):

Address:

Town/City:

Province:

Postal Code:

Email:

Phone:

Membership Status:

Membership Card #:

Want to be a volunteer? Mark your interests off with a check mark.
Ticket Selling:
Sponsorship Sales:
Door Greeter:
Raffle Sales:
Poster Distribution:

NOTE: Once you pay for your membership via PayPal, please click on the "Return to Merchant" button to complete your transaction!