Membership Application
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First Name:
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Last Name:
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Primary Telephone:
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Cellular Phone:
e-mail address:
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Mailing Addess:
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Are you an Artist?
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Could you volunteer at BRAG?
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Yes
No
If Yes, what would you prefer to do?
What type of Art Classes/Workshops would interest you?
Enter Membership status desired: Individual, Family, Patron, Business or Angel
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Method of Payment (enter "mail check", "call with credit card", or "stop by with cash")
Copyright 2008 Wild Goose Art
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