New Members Application Form by HC121105141252

VIEWS: 3 PAGES: 2

									                                                            membership application
This is a fill-able word document, which means you must double click on the grey boxes to be
able to enter your information.

     membership renewal
or
     new membership

Name(s)
Street Address
Town/City
Province                                   Postal Code
Telephone (home)        (other)
E-Mail        Website
Medium/media
   Yes, I accept commissions


*Save 10% on your VANS membership, if you belong to a gallery or group that is also a VANS
member. For example, if ARCAC is a member of VANS, all ARCAC members can receive 10%
off their VANS membership. Visit http://www.visualarts.ns.ca/gallery-group-members/ to see if
your gallery or group makes you eligible. (Please note: discount cannot exceed 10%).

Please indicate your confirmed Gallery/Group membership (one will be sufficient):


From the list below, please select one Annual Membership fee (Regular or Gallery/Group
Discount):

     Individual membership $35
     *Discounted individual membership $31.50

     Household membership $45
     *Discounted household membership $40.50

     Senior membership (60 yrs+) $30 or
     *Discounted senior membership (60 yrs+) $27

   Student membership (includes up to one year after graduation) $25
   *Discounted student membership (includes up to one year after graduation) $22.50
Institution
Student Card #

     1 year Gallery/Group membership $60
     1 year Corporate membership $65
     1 year International membership (outside Canada) $40

Please indicate the method of payment:
   PayPal

   Cheque


e-studio directory                                                                       add $10
VANS offers webspace for artists registered for our e-studio directory for an additional $10. If you
are interested in being a part of the e-studio directory, please review the submission guidelines
on our website here: http://www.visualarts.ns.ca/programs/e-studio-about/ and send the
registration form with your membership application. It is your responsibility to submit material to
the website that meets the guideline specifications for it to be approved and posted.

   renew my membership for the e-studio directory.

   add me to the e-studio directory.


Additional Support

I would like to make a $      donation toward to the work of VANS (tax receipt issued for
donations of $10 or more)

Total amount enclosed, or paid via PayPal $

If you’ve paid with PayPal, you can mail it or save this document and e-mail it to VANS as an
attachment to communicate@visualarts.ns.ca. If you wish to pay with a cheque, you can print this
form, fill it out, and send it to VANS with an enclosed cheque made out to:

                                                                         Visual Arts Nova Scotia
                                                                               1113 Marginal Road
                                                                               Halifax, NS B3H 4P7
                                                                                     (902) 423-4694
                                                                             vans@visualarts.ns.ca
                                                                        http://www.visualarts.ns.ca

								
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