Name: ___________________________
Address: _________________________
City: ____________________________
State: ____________ Zip: ___________
Home Phone: _____________________
Business Phone: ___________________
Payment: ______ Check, _____ VISA,
______ MasterCard
Card Number: ____________________
Expiration Date: ___________________
Signature: ________________________
Your tax-deductible membership contribution should be made payable
to: The Arts Council. After printing the application,
please check one of above membership categories and return the completed
application form to: P.O. Box 1632, Gainesville, GA 30503-1632.
If you have questions or need additional information
please call 770.534.2787