back                                  WRAA Membership Application 

Are you a non-professional artist who would benefit from being a member?  WRAA members receive invitations to regional WRAP exhibits and workshops,  special 'member-only' awards at the annual state exhibition and also receive WRAA's quarterly newsletter, Contour Notes.  Please print out this form and send along with your check (make payable to WRAA) to:  

WRAA Membership Chairperson, Beverly Balakhovsky, 625 Segoe Rd., Apt 902, Madison, WI 53705   wraa.membership@yahoo.com

Membership Application / Renewal

October 1, 2006 thru September 30, 20_____

______ New Member                ______ Years at $15.00 year

______ Renewal                         ______ Lifetime Membership $200.00

Please print clearly your complete mailing address.  If you move or have a snowbird address, please let us know.  Our non-profit bulk mailing of Contour Notes is NOT forwarded to you.

Name ___________________________________________________________________

Primary Address ___________________________________________________________

City _____________________________________ State _________   Zip ______________

County ________________ Phone (____)_____________ e-mail _____________________

Seasonal/Snowbird Address Information                          Dates for Seasonal/Snowbird address

Address _________________________________________         __________ to __________

City ____________________________________ State ______________ Zip ___________