The American Gospel Music Directory
Membership Application

Please print out this form, complete it and mail it to the address below.
Please select a membership category: (check one)

_____Group/Soloist       _____Publication         _____Organization         _____Business

___Other (explain)___________________________________________________

___Link to Your Existing Website - PRINT complete website address (URL) clearly below:

http://______________________________________________________________________________

Style of Music or Ministry ______________________________________________________________

Group/Org./Soloist/Business name________________________________________________________
(As you want the name to be listed on the directory)

City and State group is based in __________________________________________________________
(As you want city and state to be listed on the directory)

Contact's name_______________________________________________________________________

Address____________________________________________________________________________

City_______________________________________State_______________Zip___________________

Phone number with area code___________________________________________________________

E-mail address (if applicable)___________________________________________________________

Signature___________________________________________________Date___________________

Membership Fees
Make checks payable to Todd J Wilkins. The fee for a new web site is $75.00 ($25.00 one time set-up fee and $50.00 first year's dues). The fee for a link to your existing group website is $5.00 per year. Link to an existing business site is $15.00
Include your check with this form. You will be billed for future dues based on the month you join.
Mail this form and your check to:
Todd J Wilkins, PO Box 816, Ligonier, PA 15658-0816
A receipt can be mailed to you on request. More information is available on the Info page.
Site address: http://www.americangospel.com
Return to the membership information page.