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FVAA 2008 MEMBERSHIP FORM Fairfield Visual Arts Association 4160 Suisun Valley Road #E, Box 342 Fairfield, California 94534-4018 707.428.0400 fairfieldvisualarts.org 2008 MEMBERSHIP FORM Name___________________________________________________________Address__________________________________________________________ City _______________________________________ State_____Zip_________ Phone(Home)__________________(Work)______________________________ Phone(Cell)___________________EMail_______________________________Membership Categories and Fees (Please Check One) ___ Artist $50 ___ Student(Full-Time, maximum age 25) $20 ____Family $70 ____ Donor $50 - $500 ____ Sponsor $501 - $999 ____Patron$10,000+ How would you like to volunteer? ______ Juried Art Show ______Membership ______Children’s Workshops ____ Art on the Vine _____Gallery (Docent/Exhibits) ____Grants/Fundraising ______ Communications (Newsletter/Publicity/Web Site) _____Other Method of Payment ______ Check or Money Order enclosed in the amount of $_____, made payable to the Fairfield Visual Arts Association (FVAA) ______ Charge my Credit Card: ______ VISA ______MasterCard Credit Card Number_______________________ Expiration Date _____________________________________ Signature ………………………………………………………………………………………………Receipt THANK YOU for your donation in the amount of $_________FVAA Tax I.D. #68-0486845