(PLEASE PRINT ALL INFORMATION) SANTA PAULA SOCIETY OF THE ARTS I hereby apply for membership in the Santa Paula Society of the Arts. Name (Mr.,Mrs.,Miss,Ms.) ________________________________________ Address: _____________________________________________________ City, State and Zip _____________________________________________ Phone: (______ ) _________________Cell Phone ______________________ Email: _________________________________________________________ Memberships: General Membership /___/ $25.00 ___Associate /___/ $15.00 Lifetime / ___/ $200.00___ _________ _Patron /___/$50.00 (If joining after Dec. 31st the dues will be 1/2 the yearly dues. Dues will be due again at the full amount after June 30th) I am an ARTIST ___ POTTER ____ SCUPTOR____ NON-ARTIST____ OTHER_____ My Sponsor or Reference is ________________________________________________ Date: _______________________ Signature___________________________________ I am willing to support by working on Committees ____, Working at the Gallery ___, Helping at Special Events ____, Telephoning ___, Other ___

Please print this page, fill out and mail to P.O. Box with payment. Please do not send cash, only checks or money orders made payable to Santa Paula Society of the Arts:

Santa Paula Society of the Arts P.O. Box 788 Santa Paula, Ca. 93061-0788