McIntosh Art Association
Application for Membership
 

Date: _________

Check level of membership desired:
______ Student -18yrs. and under ($10.00)

______ Individual ($24.00)

______ Family ($30.00)
______ Lifetime ($250.00)

 

Name: _______________________________

Address: _____________________________

City: _______________, State: ________ Zip: __________

Phone: ____________________

Email: ____________________

Website Address: _________________________

Are you willing to act as a gallery host/hostess?: _____

 

Would you like to receive artist-member jury guidelines? _____