Central Mississippi Blues Society Membership Application
Fill out this form, print it, and send with a check to: P.O. Box 8314 - Jackson, Mississippi 39284 Make Checks payable to: The Central Mississippi Blues Society fee scale is located at the bottom of application
Name:
Business Name, if applicable:
Address:
City:
State:
Zip:
Email Address:
Telephone:
Fax:
Membership Level:
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