Combined New and Renewing Member Registration Form

Select One *

New Member
Renewing Member

Date *

Membership Year *

Name *

First

Last

Name(if applicable)

First

Last

Member Address *

Address Line 1

Address Line 2

City

State

Zip Code

Joint Member Address

Address Line 1

Address Line 2

City

State

Zip Code

Primary Member Email *

Email

Confirm Email

Joint Member Email

Email

Confirm Email

Primary Member Phone *

Joint Member Phone (if applicable)

How did you hear about us? Please select one. *

If you have selected "other" please give details

If you have checked other (above) please enter details (below)

If you have checked other (above), please enter details (below)

I understand that my likeness or the likeness of my artwork may be used by the Sawnee Association of the Arts for incidental advertising, website images, media and other purposes. I further understand that no special compensation will be provided for use of my image and that I may not be informed in advance of the specific use of my image. I understand that unless I opt out of this release, my likeness may be used without my specific permission as deemed appropriate by the Sawnee Association of the Arts. Note images on the website cannot be downloaded. *

I Understand and Agree

Membership Dues *

Students - $25.00
Individual - $50.00
Couple - $50.00
Family Plan ( Includes 2 adults and up to 4 children ,,,under 18 - $100.00

Membership Registration Total *

$0.00