Rockbridge Arts Guild

Membership Form
(Select print on your  browser,  fill in form and send to address below) 

Name(s) 
___________________________________________________
Address
___________________________________________________
City, State ZIP 
___________________________________________________
Phone
___________________________________________________
Email
___________________________________________________
Art Medium
___________________________________________________

 
Membership Fee Inclosed
 
All memberships
from: Jan1- Jun 30 
For new members
joining from:
Jul 1 - Dec 31
Student:
($10)___________
     ($5)__________
 Individual:
($20)___________
   ($10)__________
Family:
($25)___________
   ($12)__________
Total Inclosed:
        ___________
            __________

 
Make check payable to Rockbridge Arts Guild and mail to:  Rockbridge Arts Guild
  ATTN: Membership
  PO Box 747
  Lexington, VA 24450
Form Last Changed 6/12/07
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