Online Membership, Class Registration, Donation and/Or other item Paid by Check

If you MUST pay by check, please provide the following info to help us know you better. Required fields are marked with an asterisk; others are optional. Note that you will not be enrolled in a class until your check is received. *
Is this membership, class and/or event for you or a gift for someone else?
Is this a new membership, a renewed membership, a class, printing, studio or darkroom time, an event, and/or a donation? *
Check all that apply.
Please provide the exact title of the class or event so that you will be registered for the correct class or event. For Printing, enter "Printing" and the amount. For Darkroom or Studio time, state the hours of each type.
We need the dollar amount your check will be for.
Name of member, class enrollee, participant, and/or donor *
Name of member, class enrollee, participant, and/or donor
Note that your name, email address, street address, website and other information will not be listed or accessible on the PhotoMidwest website.
Are you 18 year old or older? *
Mailing address of member, enrolee, participant, and/or donor *
Mailing address of member, enrolee, participant, and/or donor
Preferred Telephone Number *
Preferred Telephone Number
Alternate Telephone Number
Alternate Telephone Number

Thank you. Please promptly send your check to:

PhotoMidwest,  attn Treasurer, Education & Membership
700 Rayovac Dr. Suite 212
Madison WI 53711 USA