Dublin Laurens Arts Council

P.O. Box 776, Dublin, GA 31040

Sophia Tribble
Phone (478) 275-0798

 

** New or renewing Members **

JOIN NOW for 2016-2017 !

*****

MEMBERSHIP APPLICATION
2016-2017 season
      

Membership is open to all individuals and corporations in the Dublin and Laurens County area.  To join now, please print this application, provide the information requested, and mail along with your check to the address shown.
   

             

 (Please type or print plainly)

Name ( as it should appear in our records )                                                                                             

Contact  Name ( if above is a business                                                                                               

Address                                                                                                                                  

City                                              State                Zip Code                      

Phone ( include area code )                                           Email                                                                 

Type of membership:  ( Corporate, Diamond, Gold and Silver Patrons will be listed in the program.)

Corporate  Patron                   ($1000 and up, 10 tickets)

Diamond Patron                    ($500 - $999, 8 tickets)      Gold Patron                  ($300 - $499, 6 tickets)

Silver Patron                     ($200 - $299, 4 tickets)     Individual Membership                   ($45, please enter number of memberships)

I am enclosing a tax-deductible additional gift of $_____________ specifically for the Young Artists' Showcase !!

Amount Paid                            Cash                            Check                         Date                              

NOTE : Students are admitted free with an accompanying adult member.