Membership Application Form

Cajun Heritage Festival, Inc.
PO BOX 582
Cut Off, Louisiana 70345

[ ] Renew Membership

[ ] New Membership

Rates:
[ ] $20 Couple (Husband & Wife)
[ ] $15 Single Membership
[ ] $5 Student Membership (K-12)

Name     _________________________________
Address  _________________________________
              _________________________________
City        _________________________________
Phone    _________________________________
E-mail    _________________________________