Date:___________________________ Name:_____________________________________________________________ Address:__________________________________________________________ City:_______________________ State: _______Zip Code: _____________ E-mail:__________________________ Website:________________________ Phone:__________________________ ____New Membership ____Renewal ____$20 Student ____$35 Artist ____$40 Patron ____$60 Dual ____$75 Cultural Institution Contributing Memberships ____$100 Friend ____$250 Patron ____$500 Benefactor
ARTSWorcester also offers a Business Partnership Program. Please contact us at (508) 755-5142 for more information.
Additional Contribution ($ ) Total Enclosed ($ ) I am an artist: ____visual ____performing ____literary ____I am an arts administrator/educator My area of interest is ___________________________________________ I am interested in being an ARTSWorcester volunteer: ____gallery sitting ____Biennial committee ____Office/website ____Other
Please make your checks payable to:
ARTSWorcester
660 Main Street
Worcester, MA 01610