Membership Application

Date:_________________________
Name: __________________________________________________________________
Address:________________________________________________________________
__________________________________________________________________
Phone:_____________________________e-mail________________________________

Do you consider yourself (select as many as apply):
__ Student __ Hobbyist __ Production Potter __ Functional Potter
__ Sculptor __ Ceramic Artist Other_____________________________________

Are you willing to sit on a committee? ___________________________________
Are you willing to volunteer? __________________________

Are you willing to share your e-mail address with members? Yes No

Please:
Make cheque to CCAA ,
Print and Send completed form to the CCAA.
care of:

Krista Gowland
427 129th Avenue SE
Calgary, AB T2J 5H5