New West Symphony League
Membership Application

NOTE: Dues must be received by Oct. 1 in order to be included in Directory 

Please complete the form below and click on "Submit" to complete your membership application.

To submit this form, all "*" fields must be filled in.

Please indicate your annual level of support:
Platinum: Individual $100 Couple $125
Gold: Individual $60 Couple $85

League year begins Sept. 1; new members after March 1 pro-rated at 50%)
 
Badge backing (please check one):
Magnetic
Pin
Pocket Slip-On (suitable for men's suit jackets)($4.00 extra, whether new or renewal)
Renewing members may order new badge with new logo for $10.00 each
1 New Badge 2 New Badges
No New badge
 
Additional donation:
$
 
Total*
$
 
Membership Season*
Type of Membership*
Your Contact Information
First Name*
Last Name*
Address*
City*
State*
Zip*
Home Phone
Email*
Confirm Email*
Preferred Method of Communication
Payment Information
Card Type*
Card Number*
Expiration Month*
Expiration Year*
Card Security Code*

The New West Symphony is a 501(c)(3) non-profit organization, Tax ID: 77-0406042

If you wish to pay by check, please make it payable to "NWSL" (write membership level on memo line). Print out this form and please mail it to:

New West Symphony League
c/o Nadine Kawaguchi
6307 Geyser Avenue
Tarzana, CA 91335-6832

Questions:
Call Lisa Higginbotham
(805) 910-5048
or Nadine Kawaguchi
(818) 343-4130