Membership Registration Form

Description of Membership Levels:

  • Student $25 (Must be enrolled at an educational institution that provides an art glass curriculum - Please include name of institution below)
  • Individual Artist $45 (An individual glass artist or glass enthusiast)
  • Studio/Gallery/Retailer $65 (Commercial studio/gallery or partner artists - two membership listings at same address, one website)
    • Each Additional Member $35 (Fill out separate form for each additional member of Studio/Gallery/Retailer at same address)
  • Museum/Educational Institution $125 (Museum or Institution that provides an art glass curriculum)
  • Corporate $175 (Manufacturer/publisher/distributor in the art glass industry)
Membership Level*
Username*
Password*
Email*
First Name*
Last Name*
Street Address 1*
Street Address 2*
City*
State*
Province*
Zip*
Country*
Phone Number*
Items marked with an (*) are required.
Cell Phone Number
Fax Number
Website Address
Personal Website/Blog
Company Name
Partner First Name 1
Partner Last Name 1
Partner First Name 2
Partner Last Name 2
Employer
Work Address
Work Address 2
City
State
Province
Zip
Country
Work Phone
Work Email
Work Website
Facebook Account
IM Account
Twitter Account
MySpace Account
Skype Account
Other Account 1 Name
Other Account 1 Type
Other Account 2 Name
Other Account 2 Type
Description of work
Categories Glass Artist
Teacher
Retailer
Manufacturer
Publisher
Museum/Gallery Educational Institution
High School
College/University
Specialized Art Institution
Glass Enthusiast
Other
Sub Categories Stained and/or Leaded Glass
Stained Glass Lampshades
Liturgical (Church) Glass
Pate de Verre
Dalle de Verre
Traditional Glass Painting
Fused Glass
Hot Glass/Blown or Cast Glass
Lampworked Glass
Mosaic Glass
Glass Etching/Sandblasting/Sand Carving
Custom Beveling
Pattern Designer/Maker
Repair
Restoration
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