PLEASE PRINT CLEARLY (All Memberships expire December 31)
____________________________________________________________________________
Full Name
____________________________________________________________________________
Address
________________________ ___________________________________________________
Phone Number E-mail address
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Medium(s), Interests, Special Skills
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Signature
Date
Please Choose a Membership Level:
□ Artist Basic..........................$25
□ Artist Family........................$50 (up to 2 adults and their minor children)
□ Friend of the Arts................$10 (Note: The "Friend of the Arts" membership level has no voting rites and will receive no class discounts. Will receive invitations to all events and newsletters)
Patron levels (for those who maybe aren’t artists but want to support the vision – special recognition will be given within the Gallery to these special patrons):
□ Silver Patron........................$50
□ Gold Patron..........................$75
□ Ruby Patron........................$100
□ Diamond Patron..................$101+
□ Add Member Web Page** $25
Total Due: ___________ Choose a payment method below:
□ Check made to London Visual Arts Guild)
□ PayPal:
Preferred method of contact:□ Email □ Postal Mail □ Facebook □ Other ________________________
Send this completed form with your payment (if paying with check) to:
The Gallery on High Studio 7
7 E. High Street
London, OH 4314
**The Member Web Page will be a page on the LVAG main site. Up to 30 photos, with descriptions and optional prices, of your artwork will be maintained by the webmaster. Artist is to provide all photos and information. Updates can be requested once per quarter. An example member page can be seen here: http://www.londonvisualartsguild.org/MemberGalleries/AliceSeyfried.htm Questions? Email lvag.info@gmail.com