Name_______________________________________________________________________________

☐ My contact information has not changed from the 2019/2020 membership year

☐ My contact information has changed (or I am a new member): 

Address____________________________________________________________________________

              ___________________________________________________________________________

Primary phone __________________________________________________

Secondary number ______________________________________________

E-mail _________________________________________________________________________

Website _______________________________________________________________________

Please check one of each of the following choices:

☐ I am a new member of WMPG

☐ I have been a member of WMPG for _________ years.

☐ I would like monthly newsletters sent to the above email address

☐ I prefer to have a hard copy of the newsletter mailed to the address listed above

☐ I would like my contact information listed on the website 

☐ I do not wish my contact information to be listed on the website 

Choose from the following options: 

☐ Individual Membership $50.00

☐ Studio Membership $65.00 (two or more potters working in one space)

☐ Newsletter Only $10.00

Dues may be paid online at WMPG.SQUARE.SITE or via check, made out to the West Michigan Potter’s Guild.

Please mail this completed form with membership dues (if paying via check) to:

New Members: 

Julie Devers, New Member Coordinator 34722 CR 390 

Gobles, MI 49055

Returning Members: 

Sue     Haveman, Treasurer

4620     Canterbury Drive

Hudsonville,     MI 49426

Photos:

If you would like a photo of your work listed with your contact information or would your website photo updated, please email photos to Tom Richards at tom@tomrichardspottery.com