MEMBERSHIP FORM
Yes, I want to become a member of Gallery at the VAULT
Please consider one of the categories: Membership benefits:
____Individual $20.00 Discounts in the gift shop
____Family (3+) $50.00 Reduced fees for lectures and workshops
____Student $10.00 Support of student shows
____Senior (65+) $10.00 Invitaions to gallery events
____Supporter $50.00 - $249.00 Supporting culture in downtown Springfield
____Collector $250.00 - $499.00
____Curator $500.00 +
NAME_________________________________________________________________________________
ADDRESS______________________________________________________________________________
TOWN ________________________________________________________________________________
STATE_______________________________ZIP__________________PHONE_____________________
E-MAIL________________________________________________________________________________
CHECK ENCLOSED FOR _____________________________________
Payable to:
Gallery at the VAULT
68 Main Street
Springfield, VT. 05156
Thank You!
