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Become a Friend of the Bijou, or renew your membership, by completing the form below:

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Membership Level
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$


(mm/dd/yyyy)

(if you would like to make monthly or quarterly payments, please divide total membership fee by 12 or 4 and put that number into the custom amount field and choose appropriate donation schedule from drop down menu above)

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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
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First Name
Last Name

Enter partner's email address if they would also like to receive weekly FOTB newsletter
Check this box if you would like to decline all membership gifts (mug, Bistro dinner, and/or charity tickets) and receive a tax receipt for full donation amount.