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Date

Salutation

Mrs. Ms. Mr.

First Name

Last Name

Apt

Address

City

Province

Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon

Postal Code

Telephone (555.555.5555)

Email

Nominated by

Seconded by

Are you a visual artist?

Yes No

Which of the arts are of particular interest? (choose all that apply)

Literature
Music
Photography/Film
Painting
Sculpture
Other:

In order for the WAAC to thrive, each member should be actively involved and we anticipate your strong commitment to our organization. Please complete the information below so that we may use your talents to our best advantage.

Please tell us what you are interested in? (choose all that apply)

Scholarship
Fundraising
Program (Luncheon Speakers)
Garden
Gallery Hanging
Luncheon Table Decoration
Telephone

Please tell us what business/professional experience you have. (choose all that apply)

Financial
Writing Skills
Computer Skills
Publicity
Other:

Are you available during the day?

Yes No

You will be invoiced at the address above upon acceptance. Rates are prorated based on a membership year from April 1 to March 31.

Regular Membership $225.00
Out of Town/Student Membership $75.00