Membership Application

MILLHOUSE ART SOCIETY INC.

PO Box 200 Milton NSW 2538. Gallery - Princes Highway, Milton, ph (02) 4455 7211, email: millhouse_art@hotmail.com; website: www.millhouseartsociety.com.
Membership Application
Surname*
Given name(s)*
Email*
example@example.com
Mobile phone number*
Home phone number
Address*

Street Address

Street Address Line 2

SuburbState

Postcode
Tell us about yourself - which mediums do you work in?*
What type of activities would you like to participate in?*

Self-directed art groupPlein-air/paint outside sessionsWorkshopsBus tripsExhibitionsSocial eventsFundraising activitiesCommittee memberDelivering a workshop
NOTE: Membership to Millhouse Art Society is open to residents of the Shoalhaven Local Government area only. All members are invited to attend General Meetings and other events/activities held by Millhouse. Self-directed art groups are held Tuesday, Thursday and Friday at the gallery. Millhouse is a volunteer-based organisation and as such members are required to undertaken Gallery/Exhibition duty at a minimum of one day per year and up to three days per exhibition (if exhibiting). Members are also asked to consider being involved in the Management Committee on an annual basis.
Declaration: I hereby apply to become a member of the Millhouse Art Society. By signing this form you agree to abide by the Constitution of Millhouse Art Society.
Signature*

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Date*

DayMonthYear
Date
Choose a payment option:*

Online payment (below)Bank transfer*Payment in person in the gallery

Select one item below to pay by credit card

Full year, renews each July

$40.00AUD Quantity

Part year membership, available from 1 February, renews in July

$25.00AUD Quantity

Total

$0.00AUD

Credit Card

*Bank transfer:

Payment made by bank transfer/direct deposit to Millhouse Art Society Inc.

BSB 633-000 (Bendigo Bank)

Account number 144 674 264

Use reference 'M'ship' and your initials and surname.
Should be Empty:

MILLHOUSE ART SOCIETY INC.

Membership Application

Credit Card