Membership Application Form

Please use this form to apply for membership. There are two forms of membership available:

Bi-Annual Membership: 2 images listed alphabetically by Artist name with website linking.

Full Membership: Full web page with bio details and contact information.

Only enter your credit card details if you wish to purchase membership. Credit Card details will be destroyed once payment has been taken. If you do not wish to email your card details, please click the check-box below and I will call you back instead.

Please provide the following contact information:

Name
Title
Company
Street Address
Address (cont.)
City
State/County
Zip/Postal Code
Country
Phone
FAX
E-mail

Please call me for payment:(tick if required)

Membership level required: (select one)

Bi-Annual Membership $20 or £15      

Full Membership $50 or £35                

Please enter your credit card details below:

  PAYMENT
Card Number
Cardholder Name
Expiry Date
3 Digit Security Code
Type (VISA/MasterCard)
  
Oenone Hammersley.
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Revised: 10/17/06