Name(s)_________________________________________________________________________________

Address_____________________________________________Zip _________ Phone___________________

CLASS of MEMBERSHIP (Circle one):

Active: Individual $30 Family $35

Associate: Individual $25 Family $30

Student: $15.00

Gallery Sponsor/Patron     Cezanne $50     Monet $100     Van Gogh $250

Life Member: Davinci $500 or more

Splashes Only: $7.00

This application is for (Circle one):     A new membership         Renewal of an existing membership

Basis for establishing qualifications for membership is (Check one): (FOR NEW ACTIVE MEMBERS ONLY)

____ Submission of two pieces of original artistic works for review by the Club.

OR

____Recommendation of a member in good standing. Member's Name: _______________________

I acknowledge receipt of a copy of the BY-LAWS and STANDING RULES of the Club. I have read and understand the provisions of both documents. If accepted into membership in The San Angelo Art Club, I agree to abide by all provisions of both documents including, but not limited to, the responsibility to be keeper of Kendall Art Gallery, as assigned, from time to time.

Signature________________________________________ Date _____________________________

Signature_________________________________________Date______________________________

FOR NEW MEMBERSHIPS ONLY:

MEMBERSHIP APPROVED ON (Date) _________________ ___________________________________

                                                            Name and Title of Club Officer