First Name Last Name

Company/School/Freelance

Address

City State Zip

Home Phone

Work/School Phone

FAX Email

Home Page

How long with employer? yrs. Previous News employer?

References: Must be sponsored by two SFBAPPA members in good standing. Students list two references your photography instructor, school publication director and/or faculty advisor.

1: 2:

Remarks: Include and pertinent information about your background or qualifications that might influence your eligibility for membership in SFBAPPA. Students list photojournalism courses, school publications and other activities that will support your application for membership. Also mention future school, internship or career plans.

Type of Membership:

-Active $30 -Student $20 -Life (free) - Associate $30

In an effort to better understand the interests and needs of our members, do you have any suggestions for SFBAPPA social activities or workshops you would like to see? Ideas

-Help on newsletter?

-Be a mentor or need a mentor?

-Help on still or video contest?

-Help organize photography meetings?

-Help on insurance program?

-Help on awards banquet?

-Run for office?

As a member of SFBAPPA, I agree to abide by all bylaws of the association.

Signature Date

Mail to: SFBAPPA Treasurer Scott Manchester 929 B Street Petaluma, CA 94952