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 |
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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 |
| Name or Organization*: |
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| Contact Person: |
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| Title / Position: |
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Location
(if open to the public) |
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| City* |
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| Postal code* |
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Mailing address
(if different from above) |
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| Business Phone* |
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| Cell/Other Phone |
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| Toll free |
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| Fax |
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| Email* |
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| Alternate Email |
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| Website |
|
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: |
| Choose a second category or specialty: |
|
| Choose a third category or specialty: |
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| For Arts/Culture/Heritage organizations only: |
| Choose your specialty: |
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| Fill in specialty, if not listed above: |
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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: |
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| |
Transaction Fee*: |
$ 5.00 |
| |
TOTAL: |
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| *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:
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