Headwaters Arts Membership Form

Membership Join/Renew

To become a member or to renew your membership, please complete all questions, payment information and click the Join/Renew Now button. Members will automatically be added to our Mailchimp email list where you will receive updates on shows and other events or Headwaters Arts news. Please note that memberships are for the calendar year January-December of the year you join. If you join/renew after September 1 in the current year, your membership will expire December 31 of the following year.
Date

YearMonth Day
Date
Cutoff Date

YearMonth Day
Memberships after this date expire the following year
Current Year
New or Renew?*

NewRenew
Name*

First Name Last Name
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

City Province

Postal Code Country
Phone*
Alt. Phone
Please enter a valid phone number.
Type of membership*
For Artists:

Complete this section if you are an artist.
Art Genre*
e.g. painter, sculptor, potter, etc
Art Medium*
e.g. oil, acrylic, clay, mixed media, etc
Website
How you would like to be listed on our website membership directory?*
e.g. Vincent Van Gogh - oil painter
Headwaters Arts is a volunteer run organization. Would you be interested in volunteering some time?*

yesnomaybeOther
You answered Maybe to the previous question. Could you expand on that?
What areas of the organization would you be interested in helping with? Check all that apply (don't worry, we won't overburden you!)

fundraising (sponsorship recruitment)gallery committee (organizing monthly shows)marketing committee (PR and social media)special events (Fall Festival, Arts in the Annex)Other
By submitting this form, you agree to be added to Headwaters Arts email lists in order to keep you updated about events and news.*

I agree

My Products*

Artist Membership

$50.00CAD

Supporter Membership

$75.00CAD

Student Membership

$ Free CAD

Enter coupon

Subtotal

$0.00CAD

Tax

$0.00CAD

Total

$0.00CAD

Credit Card

Membership Expiry: December 31,
Should be Empty:

Membership Join/Renew

For Artists:

Credit Card