Date: Tue Mar 21 19:06:00 2023

Individual / Contact Name:

Organization Name (if Business/Organizational Membership):

Email:

Address:

City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip: County:

Work Phone: Alternate Phone:

Date of Birth:* Gender:* Race/Ethnicity:*

*This information is collected for demographic purposes only and will be kept confidential and anonymous and will only be used in the aggregate.

Membership Rates Listed below

Individual Membership

Organization Membership

Business Membership

Number of Employees:

Affiliate Membership

Membership Rates

Individuals
Student Membership (must be a full time student)
$25 per year
Artist Professional Membership
$50 per year
Legal/Accounting Professional Membership Level I (1 to 5 years experience)
$75 per year
Legal/Accounting Professional Membership Level II (5 or more years experience)
$100 per year

Organizations
Arts Organization Membership I (Budget of $25,000 and less)
$50 per year
Arts Organization Membership II (Budget of $25,000 to 49,999)
$100 per year
Arts Organization Membership III (Budget of $50,000 to $99,999)
$200 per year
Arts Organization Membership IV (Budget of more than $100,000)
$400 per year

Businesses
Annual membership rates are based on a company’s number of regional employees and will renew on December 31:
$50..............5 or fewer employees
$125............6-29 employees
$250............30-59 employees
$500............60-99 employees
$1,000.........100-999 employees