Patron Membership

Please fill out the form below, print it out, and bring it along with your check made out to Appalachian Spirit Artist Association to the Gallery on Main and Sheffey. Gallery also accepts freewill donations of any amount.  Appalachian Spirit Artists Association is a 501 (c) 3 non-profit organization; your contributions are tax deductible.

Please provide the following contact information:

First Name
Last Name
Title
Home Phone
E-mail
URL
  Patron Membership $30.00
  Angel Donation $250.00 and up, name placed on metal plaque
  Freewill Donation
Appalachian Spirit Artist Association
Copyright © 2006 AppalachianSpirit Artist Association. All rights reserved.
Revised: 04/30/07