MEMBERSHIP APPLICATION
WHITTIER ART ASSOCIATION & GALLERY
8035 Painter Avenue, Whittier, CA 90602
562-698-8710  (phone/fax)

Name: Mr.  Mrs.  Ms. ___________________________________________________________________
(Circle one)                                                        (Please print)

Street  ___________________________________City ______________________Zip ______________

Phone #s: ________________________ Work_____________________  Cell ___________________

E-mail _______________________________   Website _____________________________________

Art Medium/Experience _______________________________________________________________

The Associated membership owns the Gallery and is incorporated under California law; therefore membership dues
and special fund raising events must cover all expenses of maintaining the Gallery and Association and its functions.  
This takes work and cooperation of all the membership.

Please indicate any of the following with which you can help:
_____ Teaching                        _____  Gardening                             _____  Newsletter production   
_____  Fundraising                  _____  Legal                                      _____  Building Maintenance  
_____  Website                         _____  Art Judging                            _____  Computer work
_____  Publicity                         _____  Exhibit hanging                     _____  Refreshments
_____  Bookkeeping               _____   Other _________________________________


_______________________________________________________________________     
Signature                                                                                Date                                             

I'm adding my tax-deductible donation of $ ____________
to support the work of the Whittier Art Association & Gallery.
Contributing Artist     _____
Associate Member     _____
Junior Member           _____