Membership Form
Memberships
To join, simply complete the form below, print it off and send it to:
North Dakota Art Gallery Association
#2 11th Avenue NW
Minot, North Dakota
58703
Annual membership type:
| __ Student / Senior 55+ | $10 |
| __ Individual |
$15 |
| __ Senior with exhibition review priviledges | $20 |
| __ Individual with exhibition review privlledges | $25 |
| __ Non profit museum or gallery |
$100 |
| __ For profit museum or gallery |
$100 |
| __ Business |
$200 |
| __ Sponsor |
$500 |
| __ Benefactor |
$1,000 |
| __ Guarantor |
$5,000 |
| __ Endowment contributor |
$10,000 |
Section you would like to be listed under on the web site:
| __ Drawing |
| __ Fine Craft |
| __ Mixed Media |
| __ Painting |
| __ Photography |
| __ Printmaking |
| __ Sculpture |
Medium of choice: _______________________________
Years of Experience: ___________
Name / Organization: ____________________________
Address:
_______________________________
_______________________________
_______________________________
Telephone: _______________________________
Email: _______________________________
Fax: _______________________________
I'd like my membership donation to support the following programs:
__ Technical assistance to art organizations
__ Coordination of additional cooperative bookings
__ Assistance to smaller arts organizations exhibiting art in their communities
__ Enhanced communication between artists and galleries
Signature:
__________________________________
Date:
__________________________________