MEMBERSHIP APPLICATION
IDAHO HERITAGE ARTISTS
NAME_______________________________________________________________________________
First Last
Address________________________________________________________________________
Street City State Zip
Preferred Telephone _______________________________________________________
Email Address____________________________________________________________
Birthday (Month/day)____________________________________________________________
Membership year is January 1 through December 31 of the current year.
Annual dues are $15
Please make checks payable to IHA
Mail Check and Application form to: Winston Bruns
Idaho Heritage Artists
18745 N Silver Tree Way
Boise, ID 83714