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:*

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

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

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

2023-24 Annual Guild Dues at $50 per Member Guild OR $75 after Nov. 30*

Did you include 2023-24 annual venue renewal Cert. fee ($10) - select yes or no*

Total Submitted (only one check req.):*

Check No.:*

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:*

2023-24 SCCQG Membership Form - Member Guilds