Join BIMA Form

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Join BIMA

NAME:___________________________________

ADDRESS:_______________________________

CITY:____________________________

STATE:__________________________

ZIP:_____________________________

PHONE#:_________________________________

E-MAIL:__________________________________

URL:____________________________________

AMOUNT ENCLOSED:___$15(individual) ___$25(group) ___$50(supportive friend)___$100(sponsor)

___$500(patron of the arts)___$1000+(benefator)__________other(Thank You!)

For Musicians

BAND or STAGE NAME:____________________________________

MUSICAL GENRE or STYLE:________________________________

Do you have CDs, tapes, or other musical merchandise that you would like included in our CD distribution program?

Y____ N____

COMMENTS:

_______________________________________________________________________

Send this form along with payment to:

BIMA
P.O. Box 234
Ferndale, WA 98248

Visit us online at: http://www.bima.com