SPACES Membership Form

Name:
_______________________________________________________________________

Address:
_______________________________________________________________________

City, State, Zip
_______________________________________________________________________

Phone: day                                                        Phone: evening
_______________________________________________________________________

E-mail:
________________________________

My membership is: new / renewal

I would like to recieve artist mailings: yes / no

Membership Level:
checkbox $10 Student
includes participation in our annual members' show and sale.
checkbox $150 Advocate
includes the above benefits, plus a total of $25 in SPACES Art
Bucks, and a special artist-made gift.

checkbox $20 Artist/Senior
includes participation in our annual members' show and sale.

checkbox $35 Ally
includes the above benefit, plus choice of an exhibition catalog.
checkbox $300 Activist
includes the above benefits, plus a total of $50 in SPACES Art Bucks.
checkbox $500 Art Angel
includes the above benefits, plus the free use of SPACES gallery
for one event, and a total of $75 in SPACES Art Bucks.
checkbox $75 Aficionado
includes the above benefits, plus all current and upcoming catalogs, and $10 in SPACES Art Bucks.

Make All checks payable to SPACES

Amount Enclosed: _____________________

Does your Employer have a matching gift program?

checkbox Form enclosed/ Will follow

checkbox Not Applicable

SPACES memberships are valid for one year and are 100% tax deductible.

SPACES
2220 Superior Viaduct
Cleveland OH 44113

email: spaces@apk.net
URL: www.spacesgallery.org