MEMBERSHIP APPLICATION FORM

• Copy or print, fill in and return this Membership Form with your check to OIA.
• For your artist file please include your resumé, and either your website, a CD of your work, or a sheet of 20 slides.
• Existing members may use this form to update address, telephone or other details.

Name                                                         Address

City                                                             State               ZIP

E-mail                                                        Website

Telephone

Medium:
Painting ❑  Drawing and Paper ❑  Graphics ❑  Artists Books ❑  Digital Art ❑  Sculpture: Indoor ❑ Outdoor ❑ Installation: Indoor ❑ Outdoor ❑  Photography ❑  Other ❑
I am a new member $75    ❑ I am renewing my membership $60    ❑ Student/Senior (ID required) $50 ❑

I would like to donate $          .  All donations are tax deductible to the full extent of the law.

Make checks payable to: Organization of Independent Artists (OIA).

Send to: G. Cosentino: Director, Organization of Independent Artists,

117 Sterling Place, #8, Brooklyn, NY  11217