Date:
_________
___New
___Renewal
Membership
Application
Name:
___________________________________________________________________
Street:
_________________________City:__________________State:____Zip:________
Telephone
:(_____) _______________e-mail: ____________________________________
Membership
Categories
_____Student/Senior $10.00 _____Exhibiting $25.00
_____Individual $15.00 _____Contributing $50.00
_____Sustaining $100.00+
Creative
Medium: _________________________________________________________
Please
briefly describe your work: ___________________________________________
________________________________________________________________________
________________________________________________________________________
Your website:
________________________________________________
I
am interested in the following Programs:
____Art
On Tour
____City
Hall Gallery
____Colors
of Fall
____Juried
Art Show
____Members
Only Show
____On
My Own Time
As a
member, I would be interested in future consideration as follows:
______a
volunteer, when needed
______a
member of the Board of Directors
______other
(Please Specify) _____________________________________
Please
return completed Membership Application and your remittance to:
c/o MEMBERSHIP