Online Membership, Class Registration, and/or Event Paid by Check

Please provide the following info to help us know you better. Required fields are marked with an asterisk; others are optional. *
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, and/or an event? *
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.
We need the dollar amount your check will be for.
Name of member, class enrollee, and/or event participant *
Name of member, class enrollee, and/or event participant
Note that your name, email address, street address, website and other information will not be listed or accessible on the PhotoMidwest website.
Mailing address of member, enrolee, and/or participant *
Mailing address of member, enrolee, and/or participant
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