Membership Application
| Date _______________ Please check your choice(s) in the entries marked with an asterisk *. First Name ___________________ Last Name _____________________ Address ____________________________________________________ City ___________________________ State ________ Zip _________ Phone ____________ Email Address ____________________________ Deliver Newsletter:* By Regular Mail ( ) By Email ( ) Interests:* (check all that apply) Baskets ( ) Ceramics ( ) Drawing ( ) Jewelry ( ) Literary ( ) Metalwork ( ) Music ( ) Painting ( ) Sculpture ( ) Textiles ( ) Weaving ( ) Wood ( ) Other _____________________________________________ Might you be willing to Volunteer?* (check all that apply) Committees ( ) Help at Events ( ) Public Relations ( ) Teaching ( ) Telephoning ( ) Other _____________________ Membership:* Regular-$20 ( ) Sudent or Senior-$10 ( ) Benefactor-$50 ( ) Patron-$100 or more ( ) Mail to: Pacifica Arts Guild P.O. Box 351, Williams, OR 97544 We welcome checks, but please DO NOT send cash. For information call 541-846-7838 or 541-846-6024 |