| Initial Membership
- month of receipt to the next year (e.g. if recv'd in July 08
membership will end 7-09)
Date:
Name:
Email address:
Address:
City: State: Zip:
Phone (w/ area code): Day: Evening:
Other Media or areas of interest:
Type of Membership: [ ] $15.00 Individual [ ] $50.00 Contributing
[ ] $100.00 Supporting [ ] $200.00 Patron/Corporate [ ] $500.00
Sponsor
[ ] $25.00 Fee for Artist Gallery on Planet Collage Web Site
(request details before payment is made)
----------------------------------------------------------------------------------------------------------------------------------------------------
Please check all that apply:
[ ] Practicing Artist [ ] Art Appreciator [ ] Student [ ] Patron
I am interested in:
[ ] brick and mortar show(s) [ ] postcard exchange [ ] Altoid
(candy tin) exchange
[ ] online show(s) [ ]Contributory writer for webpage [ ] Guest
juror/judge/critique
Please e-mail my newsletter in PDF format [ ] Yes [ ] No
I understand that this collage organization offers free activities
(monthly postcard exchange and periodic candy tin exchange) to
the art community at large. I am aware that my membership entitles
me to online delivery of newsletters, participation in brick and
mortar shows and/or virtual shows as available. In addition, an
optional ephemera exchange will be held in March of each year.
The membership period is yearly - beginning the month of receipt
with membership renewable beginning the month of the next year
All rights reserved 208 © ® Planetcollage.com est. 9-2006
|