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Please complete all fields marked*

Your name:*
Address:*
City/State*
Zip*
Phone (hm):*		Phone (cell):
Phone (work):
Email address:*
Website address:
If you are an artist, what Is your medium(s)
Volunteer?	Check here if you are able to volunteer time to an ArtWorks committee, event, or community project.
Supporters: $30+ (By checking this, you will be charged $30. If you would like to contribute more, see Optional Add'l Contribution  below.)	Individuals contribution $30 or more will receive their names listed (optional) on the Sponsors & Supporters Webpage.  Supporter members will receive invitations to  ArtWorks art receptions and exhibitions.  Supporters will receive an appreciation certificate, and receive a tax deduction receipt from ArtWorks, Inc., a 501(c) (3) non-profit corporation.
Gallery: $100+ (By checking this, you will be charged $100. If you would like to contribute more, see Optional Add'l Contribution  below.)	Galleries contributing $100 or more will receive their logo and a link to their home page on the  Sponsors & Supporters Webpage.  Gallery members will receive invitations to  ArtWorks art receptions and exhibitions.   Members may advertise their gallery exhibitions on the Bulletin Board Webpage free of charge.  Gallery members will receive an appreciation certificate, and receive a tax deduction receipt from ArtWorks, Inc., a 501(c) (3) non-profit corporation.
Corporate: $250+ (By checking this, you will be charged $250. If you would like to contribute more, see Optional Add'l Contribution  below.)	Corporate members contributing $250 or more will receive their logo and a link to their home page on the  Sponsors & Supporters Webpage.  Corporate members will receive invitations to all ArtWorks art receptions and exhibitions.  Members may advertise their corporations art exhibitions on the Bulletin Board Webpage free of charge. Corporate members will receive an appreciation certificate, and receive a tax deduction receipt from ArtWorks, Inc., a 501(c) (3) non-profit corporation.
Optional Additional Contribution (Non-Profit EIN# 113820488):
	$5	$10	$25
	$50	$100	$500
	$1,000	$2,500	$5,000
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