MEMBERSHIP FORM
Please provide the following information to purchase a Kansas City Artists Coalition membership. Memberships are available online at these levels: $45 individual renewal; $50 individual; $75 family; $100 patron; $250 major patron (If you are purchasing a renewal, you must do so before your individual membership expires). To purchase memberships at other levels { download the membership form }

The first letter you enter in the last name field is how you will be alphabetized.
Please note that fields with an * are required

PERSONAL INFORMATION
date*	mm/dd/yy
first name*
last name*
middle name
additional name	family membership only
title	if applicable
organization	if applicable
home phone*	000-000-0000
studio phone	000-000-0000
work phone	000-000-0000
fax	000-000-0000
address*
address continued
city*
state/province*
postal code*	00000-0000
country
email
url
IDENTIFY AND DESCRIBE YOURSELF
ethnicity
date of birth
gender*	male female
interests	auction board/committee exhibition open studios volunteering workshop
artist*	yes no
ARTIST INFORMATION (IF APPLICABLE)
discipline (3 max)	architecture assemblage book art ceramics collage computer-generated craft design drawing fashion fiber art furniture glass art illustration installation jewelry mural new genre painting papermaking photography printmaking public art screen printing sculpture video/film weaving
media (3 max)	acrylic bead bronze clay color pencil concrete digital enamel etching fiber film glass gouache intaglio lithography metal mixed media oil paper pastel pen & ink pencil precious metal relief silver gelatin stone video watercolor wood
style (3 max)	abstract color field conceptual contemporary decorative documentary expressionist figurative functional impressionist minimalist mixed styles narrative new genre non-representational op art pop art realist representational surrealist traditional whimsical

{ endowment }

{ membership }

{ sponsorship }

{ volunteering }

{ sitemap }