ART ASSOCIATION OF HARRISBURG
Official Membership Application

Name

Membership Level (please check one)

Address           Student (all ages!)......................$25
City   State   ZIP Artist.........................................$40
Home Phone     Work Phone Supporter...................................$50
Credit Card Visa  MasterCard Discover American Express Promoter....................................$75 
CC Number    Exp. Date  Patron......................................$125
E-mail Address Benefactor................................$250
Sponsor....................................$500
Friend.....................................$1000
Signature    _________________________________________
Membership is valid for one year from receipt of application.
Make checks payable to Art Association of Harrisburg (AAH).
Mail to: 21 North Front Street, Harrisburg PA, 17101.
Platinum Life...........................$5000


Instructions:
Complete all areas, then print and sign the form.  Don't forget to click a box at the right!
Mail the completed form, along with your payment, to:

Art Association Of Harrisburg
21 North Front Street
Harrisburg, PA 17101

Questions?
Give us a call at (717) 236-1432.