Membership Form - Wickford Art Association

MEMBER INFORMATION

Date of Renewal*

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Phone Type*

Home
Mobile
Business
Other

Email*

Website

For Artist Members ONLY, please start with http/https...

Primary Medium

If you are an active artist, please identify the medium in which you primarily work.

Second Medium(s)

If you are an active artist, please identify any secondary medium(s) in which you work.

Social Media Site/Handle

Where can WAA find you on Facebook, Instagram, Twitter, etc.?

Employer

(Optional) WAA seeks to gather more information about the professional affiliations of our members.

MEMBER TYPE & LEVEL

Please select one of each below. *JAM memberships are only available to those who successfully pass a JAM Jury Panel – the next JAM Jury Panel will occur in November 2021.

Membership Renewal (Jan 2023 - Dec 2023)

Note: Family memberships are for 2 adults and all children in household.

WISH TO VOLUNTEER?

Volunteers are a major asset to our organization! Please let us know your interests, and areas in which you could actively participate in the association. Many tasks are one-day commitments, others multi-day scheduled at your convenience.

Volunteer Interests

Donation

Optional Tax Deductible Donation

Payment

Total

$0.00

Credit Card*

Card Details

Cardholder Name

Billing Address*

Same as Address Above

Phone

This field is for validation purposes and should be left unchanged.