Perth Arts Connect Membership Application

Choose a membership category:

Artist –Artisan (individual) - $25

Not-for-Profit Arts, Culture or Heritage Org. - $50

For Profit- Arts, Culture or Heritage Sector - $75

Microsite option: (in addition to membership)

Artist/ Not-For-Profit Organization Members - $50

For-Profit sector - $100

This is a: New Membership     Renewal
If this is a new membership, please fill in as much information as possible.
If renewing you only need to fill in the required (green*) boxes below:

Membership Information
  1. Name or Organization*:
  2. Contact Person:
  3. Title / Position:
  4. Location (if open to the public)
  5. City*
  6. Postal code*
  7. Mailing address if different from above)
  8. Business Phone*
  9. Cell/Other Phone
  10. Toll free
  11. Fax
  12. Email*
  13. Alternate Email
  14. Website
  15. Short Description of your business or service
    (15 to 20 words or 100 characters)

Choose the page you think your listing should appear on:

Referring to that page on our website, note the category headings in the right-hand column. Under which heading should your listing appear?
If your desired heading doesn't appear on that page, name it:

For individuals only:
  1. Choose a second category or specialty:
  2. Choose a third category or specialty:
For Arts/Culture/Heritage organizations only:
  1. Choose your specialty:
  2. Fill in your specialty, if not listed above:

I understand that the information provided above (excluding any exceptions listed below) will be used by Perth Arts Connect in
the following ways:

  • In on-line and printed directories designed to promote arts, culture and heritage in Perth County;
  • To contact me with information of interest to Perth Arts Connect members;
    May be provided to members of the public inquiring about my artistic specialty(s)/business; and
  • Published info may be shared where there is a reciprocal relationship with another member not-for-profit arts organization.

For the purposes of the Freedom of Information and Protection of Privacy Act, I/we authorize and consent to the use of my/our name and address by Perth Arts Connect on the PAC membership webpage.

Perth Arts Connect protects personal information and does not sell, rent or allow access to this information except as above.

Upon submitting this form you will be directed to PayPal's secure payment form to complete your payment.

Your order total is:
Membership:$   _____ Transaction Fee*:$   5.00 TOTAL:$   _____

*P.A.C. membership fees are not subject to HST. However, due to PayPal fees, we are adding a $5.00 transaction fee.

Please enter the number you see next to the box: