Member Guild Membership Form

Guild Name*

Mailing Address*

City, State, Zip*

Website URL

Website email contact

Facebook Information

Instagram Information

Guild meets: Day and Time*

Guild meeting address:*

Guild officers change (month):*

President*

President Phone No. (for emergency only):

President E-mail Address:*

Program Chair*

Program Chair E-mail address:*

Newsletter Editor*

Newsletter Editor E-mail address:*

SCCQG Representative*

SCCQG Rep E-mail address:*

Treasurer*

Treasurer E-mail Address:*

Please indicate number of members in the guild. This number should reflect your membership at the close of your most recent guild year.*

Is Guild opting in to participate in the SCCQG liability insurance policy? Select yes or no.*

Insurance premium due for Member Guilds only (multiply number of members by $5.25 per person)

2025-2026 Annual Guild Dues at $50 per Member Guild OR $75 after Nov. 30*

Did you include 2025-2026 annual venue renewal Cert. fee ($10) - select yes or no*

List Facility Name(s) for any Cert Fees Included:

Total Submitted (only one check required)*

Check No. (made payable to SCCQG):*

Date Check Mailed to Treasurer, SCCQG, 15619 Ogram Avenue, Gardena, CA 90249. DO NOT send her anything other than the check, with your guild name and check purpose on memo line.*

Name of Person Completing this Form:*

Email address:*

Enter single guild email to be viewed instead of personal data (for scam/phishing/harvesting protection). The above emails are required for direct communication with guilds through our Constant Contact email service.

If no generic email is provided, please indicate YES or NO as to whether we can post the individual officer emails on your website page. *