AMERICAN GUILD OF VARIETY ARTISTS
MEMBER CHANGE OF ADDRESS
CHANGE OF EMAIL ADDRESS
TODAY’S DATE _______________________
LEGAL NAME _____________________________________________
STAGE NAME _____________________________________________
SOCIAL SECURITY NUMBER __________________________________
AGVA MEMBERSHIP NUMBER _________________________________
CURRENT EMAIL ADDRESS __________________________________
OLD ADDRESS ____________________________________________
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NEW ADDRESS ___________________________________________
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Please mail this completed form to:
American Guild of Variety Artists
363 Seventh Avenue – 17th floor
New York, New York 10001
ATT: Membership Department