Artists' Fellowship Inc. Membership Application

Artists' Fellowship Inc.

47 Fifth Avenue, New York. NY 10003
Membership Application
Name*

PrefixFirst NameMiddle NameLast Name
Organization/ Company
Provide organization/company name ONLY if applying for organizational membership
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Email*
example@example.com
Indicate membership choice:*

Active (Artist) Annual Dues $40Sustaining (Lay) Annual Dues $60Organization (Corporate) Annual Dues $275
PLEASE NOTE: We ask that you pay your first dues payment (below) with this application, if for any reason you are not approved you will be refunded the full amount.
Candidates for Artist (Active) Membership: (Check the type of art you practice and for which you receive compensation)

PaintingSculptureIllustrationGraphicsDrawingPrintmakingPhotographyOther
Organizations and clubs in which you are a member:
Candidates for Sustaining (non-artist) Membership:
type of business
Organizations and clubs in which you are a member:
Candidates for Organization/ Company Membership :
Nature of Business *Organization/Company members do not vote but are informed of General Membership Meetings and other membership activities at which their representatives are welcome.
All candidates please complete the following.

Candidates for any class of membership must be proposed by a member.
Proposed By:
I am not familiar with a current member and request the Membership Committee to sponsor me.

Pay for your membership here:

Artists Membership$40.00

Sustaining Membership$60.00

Organization (Corporate) Membership$275.00

Total $0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Signature
If for any reason your membership application is denied by the board we will refund your membership fees.
47 Fifth Avenue New York, NY 10003 212-255-7740 ext: 216 info@artistsfellowship.org
Note: The Artists' Fellowship, Inc. is a 501 C3 organization. Membership dues and any other donations are considered charitable donations and may be deducted as per section 170 of the Internal Revenue Service code.
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