Online Artist Membership Application

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This site is made
possible with the support
of The Connecticut
Commission on
Culture and Tourism.

We want to hear
from you!
Please take the time to fill out our Arts Questionnaire.

Individual or Family Membership Application

Individual Membership is $15 per year.
Family Membership is $25 per year.

Contact Information

Name:
Email: (Invoice for member dues will be sent via e-mail to the email address provided).
Phone:
Street Address:
Street Address 2:
City:
State:
Zip:

Would you like to be listed in our online Directory?	Yes No

Would you be interested in volunteering for MAC?	Yes No

Would you utilize MAC's interactive online calendar for publicity if available?	Yes No

Please list any other ways which you believe a Local Arts Agency can be of help to you and/or your organization:

Thank you for your support. Your MAC Membership will become activated upon receipt of your check or money order.

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Street Address 1:	<%# ( ( IDataRecord ) Container.DataItem ) [ "Address1" ] %>
Street Address 2:	<%# ( ( IDataRecord ) Container.DataItem ) [ "Address2" ] %>
City:	<%# ( ( IDataRecord ) Container.DataItem ) [ "City" ] %>
Zip:	<%# ( ( IDataRecord ) Container.DataItem ) [ "Zip" ] %>
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