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Club membership form template - Get as DOC - DOC by vcl99353

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									To be included in the Arts Database Cultural Mapping project of the Sudbury Arts Council you are requested to complete
this form (please read both pages – see reverse or page two on website). NOTE: You do not have to be a paid member
to be included in the Arts cultural mapping database or be listed on the website or in any specials publications of the Arts
Council. Those with voting privileges can exercise their rights at annual and any special meetings of the Arts Council
and are eligible to hold office on the Board of Directors of the Council. In addition those with voting rights are entitled to
bio and photo on the Council website. Questions: e-mail sac.communicate@gmail.com

SECTION 1: MEMBER – DATABASE CONTACT INFORMATION – FILL IN ALL APPLICABLE BOXES:

 TITLE                   Mr           Mrs           Miss           Ms           Dr           Other, specify:

 FULL NAME

 GROUP                                                                                       WORK TELEPHONE

 BUSINESS                                                                                    HOME TELEPHONE

 ADDRESS                                                                                      MOBILE PHONE

 ADDRESS                                                                                      PRIMARY EMAIL

 TOWN/CITY                                                                                    SECONDARY EMAIL
 POSTAL                                                                                       INTERNET WEB-
 CODE                                                                                         SITE

SECTION 2: MEMBERSHIP – DATABASE TYPE AND VOTING RIGHTS COST
                                                                                                                      Arts Council        Please
 MEMBER TYPE                  DESCRIPTION                                                           Non-Voting
                                                                                                                      Voting Rights       Tick
 REGULAR/VOTING               Individual (professional or amateur) Artist membership                      0               $20.00
                              Any non-profit group or organization involved in any aspect of the
 GROUP OR
                              arts in Greater Sudbury and area. Voting rights for one                     0               $30.00
 ORGANIZATION
                              identified group member).
                              Any individual or family interested in the mandate of the Sudbury
                              Arts Council to Connect, Communicate and Celebrate the
 PATRON                                                                                                $15.00          $25.00 Voting
                              Arts. One Identified family member can have voting rights for
                              an additional $10.00
 BUSINESS                     Membership donations of up to $75.00 entitled to tax receipt and
                                                                                                       $25.00          $35 - $75.00
 SUPPORTER                    $35.00 and over to one identified staff member vote.
 PAYMENT METHOD                     money order       Cheque       Other                           Include payment with this form

SECTION 3: ARTIST MEMBER INFORMATION – Complete applicable boxes

 YOU DESCRIBE YOURSELF AS:

 SPECIAL AREAS OF INTEREST:

 OTHER ORGANIZATION AFFILIATION:

 APPLICABLE EDUCATION/TRAINING:

 OTHER AREA(S) OF ARTISTIC ENDEVOUR:

 RELATED INFORMATION;

 ALL CLASSES OF MEMBERSHIP ARE REQUESTED TO PROVIDE INFORMATION AS INDICATED ON REVERSE (PAGE
 TWO) OF THIS FORM TO ASSIST IN THE ARTS DATABASE CULTURAL MAPPING PROJECT OF THE ARTS COUNCIL.
 YOU MAY SEND THIS INFORMATION BY REGULAR MAIL TO OUR PO BOX (BELOW) OR BY E-MAIL TO
 sac.communicate@gmail.com

 Note: All SAC members regardless of category receive by e-mail SAC Arts “Bulletins” (unless otherwise advised). All membership classes have
 their phone, regular mail and e-mail and/or website address listed on the website. Those with voting privileges can have a brief bio and picture
 posted on the SAC website. Memberships are renewable annually.

 Make cheque or money order payable to the Sudbury Arts Council PO Box 1382, Sudbury, Ontario P3E 5K4

 Signature:
                                                      Date                 Payment confirmed         Receipt issued         Entered into DB
Arts, Heritage and Cultural Directory – Page Two – Directory Information Input Request:

The information is being collected by the Sudbury Arts Council/City of Sudbury in collaboration with the
Community Arts and Heritage Education Project: There is no cost to be included in the directory.


         If you are interested in having your Arts, Heritage or Cultural Organization, Group,
         Guild, Association or Arts-Related Business listed in the Sudbury Arts and Heritage
         Directory then in addition to the information provided on the front (page one) of this
         application please include and submit the following on separate sheet:

    1.   Full name of the organization (group, guild, association, arts-related business)
    2.   Date of inception and listing as Commercial or Not-For Profit and/or Charity
    3.   Two to three paragraphs about your organization and the programming you offer.
    4.   Name of the contact person for the organization
    5.   Address/Postal Code/Phone/Fax/Email/Website

         Note: To have your information also published in French please include translation.

         If you are an Elder, artisan, artist, heritage programmer or traditional crafter and are
         interested in having your name listed in the Sudbury Arts and Heritage Directory then
         in addition to the information provided on the front (page one) of this application
         please include and submit the following on separate sheet:

    1. Name (first and last)
    2. Discipline or Craft (Visual Art, Music, Theatre, Dance, Heritage Programmer, Leather Work,
       Beading, Storyteller, Quill Work, Pottery, Fabric Art, Glass, Photography, Jewellery, Multi-
       Media, Film, Literary Arts, Computer Art)
    3. Three to four sentences about your work and what you do
    4. Phone/Fax/Email/Website

         Note: To have your information also published in French please include translation.

Do you wish this information to be included in a printed public directory: Yes______ No _____
Do you with this information to be posted on the internet: Yes ____ No _____

Are you interested in having this information shared with other communities in Northwestern and
Northerneastern Ontario: Yes ___ No ___ All of Ontario: Yes ____ No ___ Canada: Yes ___ No
___.

This form and related information can be emailed to sac.communicate@gmail.com or by regular
mail to: Sudbury Arts Council PO Box 1382, Sudbury, ON P3E 5K4. If requesting voting rights in
the Sudbury Arts Council please indicate on the front of this form and include appropriate amount by
cheque.


         The Arts, Heritage and Cultural Directory will be distributed to and used by artists,
         community groups, guilds, associations, heritage programmers, educators, crafters,
         artisans, community based organizations, tourists, arts and heritage organizations and arts
         related business. It may also be distributed to the community at large, by print and/or
         electronic means including the internet.

         The directory will contain contact information and will allow easy access for anyone using
         the directory to be able to contact arts, heritage or cultural organizations, community based
         organizations, artists and heritage programmers, local arts related business, crafters or
         artisans in Sudbury. The directory will list the programming that is available in ARTS,
         HERITAGE and CULTURE within the community.

         We sincerely thank you for your interest and involvement.

         Barbara Constantine, President, Sudbury Arts Council – 673-4443
         Suzanne McCrae, Communications Co-ordinator – sac.communicate@gmail.com.

         Sudbury Arts Council: www.SudburyArtsCouncil.org – 560-5412

								
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