APPLICATION FOR MEMBERSHIP

Name:

Address:

City

St

(Zip+4)

Home Phone:

Work:

E-mail:                                                      Website:

Do you want emails about events, exhibitions, etc. sent to you?                   Y                     N

If you DO NOT want your name automatically listed on CoCOA's Website (under Members) let us know here.    N

Annual Membership

(circle the amount enclosed)

1.  New Members or lapsed membership:

$ 50.00

Check website for benefits

2. Student and Senior (65+)Membership :

$30.00

Check website for benefits

3.  Friend of The Arts:

(non-artist supporter)

CoCOA is a 501(3)(c) non-profit organization, donations are tax deductible

$20.00 or more

Donation of $20 or more

WHEN CAN YOU HELP?

Weekends

Weekdays

Evenings

Short Notice

SPECIAL SKILLS?

Applicants please sign below. Your signature will attest to the understanding that this is a cooperative endeavor and that they will be expected to help in some capacity. While we make every effort to protect your artwork, artists understand that they exhibit at their own risk.

Signature:

Date: