ArtLab

ArtLab Registration
Are you a Polk Museum of Art Member?*

YesNoNo, but I would like to join (+$50 individual membership)No, but I would like to join (+$80 family membership)
How would you like your name to appear on your membership card, mailings, and in the PMoA magazine?*
(ex. Dr. John and Ms. Jane Doe, Mr. and Mrs. John Doe, John and Jane Doe, etc)
Member Number*
More information about membership at Polk Museum of Art available here.

ArtLab

Please complete each section below.
Total Number Attending
Total Number Attending*
Total Number Attending*
Total Number Attending (Members)
Total Number Attending*
Total Number Attending
Total Number Attending
Total Number Attending
Counter -1250
Actual Attending
Of the above attending, how many are...
Adults*
Teens (14-18 yrs)*
Children (5-13 yrs)*
Attending Type Total
Children attending ArtLab must be accompanied by an adult.
The total number of Adults, Teens, and Children listed must match the total number attending.
Sum: Adults Teens Children

Payment
Join as a Member Fee
Workshop Membership Discount
Workshop Cost
Workshop Fee
Total (Hidden)
Payer Name*

First NameLast Name
Payer Phone Number*
Payer Email*
example@example.com
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Total
ArtLab is FREE for Polk Museum of Art Members! Please check the Confirmation box below and press "Submit" to complete your registration.

Discount Code
Confirmation*

BY ACKNOWLEDGING AND CLICKING "SUBMIT" BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Should be Empty: