Welcome to The Nanaimo Blues Festival

Nanaimo Blues Society
Membership Application Form

Please Select a Nanaimo Blues Society membership type:

$5.00 for youth
$10.00 for singles
$18.00 for a family

When you submit the form below you will be contacted by email regarding payment using PayPal. In the email will be a link to the PayPal website where you can pay using your PayPal account. if you don't have a PayPal account, you can also pay at the same site by Visa or MC.

First name:

Last name:

Address:

City:

Province:

Postal Code:


Home Phone:		Work Phone:
Mobile Phone:		Fax:
Email Address:

Are you interested in volunteering?

Yes:

No: