Membership Form

Membership Form

Please print this form and mail it to the following address:   

Arts Alliance of Greater Lake Mills
 PO Box 352
 Lake Mills, WI   53551

I would like to become a member of the Arts Alliance of Greater Lake Mills.

___    Sponsor  $100
___    Family  $35
___    Individual  $25
____  Student $5

Make checks payable to the Arts Alliance of Greater Lake Mills

Date      _____________
Name   ____________________________________________________________
Address  _________________________________________________________
Telephone Number    ___________________________
Email        ___________________________
Website    ________________________________

Tell us a little about yourself-
Professional   _____     Hobbyist   _________    
Visual artist, what medium?   ________________
Literary artist, special interest   ________________
Performing artist, what discipline, what instrument? ________________
Arts Advocate/Art Patron     __________________
What special interests do you have   _____________________________

Additional Comments: _____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________ _____________________________________________________________________________

Thank you for your support of the Arts Alliance!