Membership - Polka Booster Club of America

Membership Form

Join the Polka Booster Club of America!

Your membership helps keep polka music alive and thriving!

📌 Annual Dues:
$15 per person | $30 per couple

📌 Member Perks:
✔️ Exclusive “Member” discount on all dances
✔️ Membership Appreciation Punch Card – Get a punch for each dance you attend. After five punches, you’ll be entered into a special drawing for appreciation gifts! (In 2024, President Mindi donated beautiful gift baskets for lucky winners.)
✔️ Membership Appreciation Picnic – Enjoy a summer gathering in July as our way of saying thanks!

Fill out the form below to join, then submit your payment via PayPal.

We can’t wait to welcome you!

First Name

Last Name

Address

City

State

Zip Code

Spouses Name

Anniversary Date (MM/DD/YY)

Birthdate (MM/DD)

Home Number

Mobile Number

Emergency Contact Name

Emergency Contact Phone No.

Membership Payment Method

Check Paypal Other

Newsletter Preference

Print Email

Payment Options:

✔️ Pay Online: Click the PayPal button below to pay securely with PayPal, debit, or credit card.

✔️ Pay by Check: Make your check payable to Polka Booster Club of America and mail it to:

Polka Booster Club of America
c/o Michael Biesiadecki
25120 Doxtator
Dearborn, MI 48128

The Polka Booster Club of America is dedicated to promoting polka music through fellowship and social activities, celebrating our shared love for polka music. Our mission is to unify and support polka organizations, enhancing and promoting the joy and tradition of polka music across communities.