Join
Us!
Please
print this form and return to the Coos Art Museum at 235 Anderson, Coos
Bay, Oregon 97420.
|
|
Join
Us!
|
| Memberships: |
| _____ $15 Student |
| _____ $45 Individual |
| _____ $70 Family |
| _____ $150 Business/Active Supporter |
| _____ $250 Gallery Club |
| _____ $500 Curator's Circle |
| _____$1000 President's Circle |
| _____$2500 Benefactor |
| Name _________________________________________ |
| Spouse's Name __________________________________ |
| Address ________________________________________ |
| City ______________________ State ______ Zip _______ |
| Phone Day ___________ Phone Evening _____________ |
| How do you wish to be listed in Museum records?_________ |
| _______________________________________________ |
| Would you like to receive CAM updates via email? Y N |
| Email address ___________________________________ |
| Membership Fee $_________ |
| Additional Contribution $_________ |
| (for:______________________ ) |
| TOTAL Enclosed $_________ |
|
Please
print this form and return to the Coos Art Museum at 235 Anderson, Coos
Bay, Oregon 97420.
|