Artist Care Act support form

Artist Care Act

Support Form
Thank you for your support of the Artist Care Act and all it is doing to try and bring about awareness and change for the arts community. By filling out this form you are join a list of people, non artists and artists alike, who are fighting for change and better representation for the arts and its workers. This will come in the form of financial support, mental health benifits, and physical health benifits. Below you will find a donations tab to help aid in completion of the documentary that goes with this bill and furthuring the reach of this bill beyond our community of artists. Please give what you can if you can. Again, thank you.
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Donation Amount:

prevnext( X )
USDDescription

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.