Membership Application/Renewal Form

igga.org

MEMBERSHIP APPLICATION
International Guild of Glass Artists, Inc.
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member application.

Mail form and payment to:
Katherine Bell, I.G.G.A. Membership Director
4735 Waverly Lane
Jacksonville, Florida 32210 U.S.A.

Date of Application: _________(MM / DD /YY)
____ New Membership  ___Renewal 
_____ Name/Address Changes Only

You can also FAX this page to: (904) 388-4213  or  you can register online by visiting: www.igga.org
Membership Levels (check only one):
Rate

_____ Student (Indicate institution name below)
$25

_____ Individual Artist
$45

_____ Studio/Art Gallery (includes owner & partner)
$65
      _____ Add'l Member Studio/Art Gallery
                 (please fill out separate form for each additional member)		 $35
_____ Museum/Educational Institution
 $125

_____ Corporate
$175

Total Amount to be paid $_________
 Please make checks payable to I.G.G.A. Funds must be drawn in U.S. funds on a U.S. bank.
 ARTIST/STUDIO INFORMATION: (Please print Clearly - All Information is required for IGGA Administration)

________________________________________________
   Member Name
________________________________________________
   Partner Name
________________________________________________
   Shop or Studio Name
________________________________________________
   Mailing Address Line 1
________________________________________________
   Mailing Address Line 2
________________________________________________
   City                         State/Prov.   Zip/Zone      Country
________________________________________________
   Phone                             FAX
________________________________________________
   Primary E-mail address

http://___________________________________________
Please check all the categories that apply or write a short (50 words or less) description of your work for inclusion on our web site. (Text may be edited for length.)

___glass artist ___teacher     ___retailer  
___manufacturer  ___publisher  ___museum/gallery
___educational institution
___________________________________
___________________________________
___________________________________
Show Artist/Studio Information
on the IGGA Website?* ___Yes ___No

* We will include your Artist/Studio information on our website only if you give us permission. IGGA is committed to working with the Internet community in cultivating and maintaining trust between ourselves and all its users.
PRIVACY POLICY: The information you voluntarily provide herein (names, email addresses and any other contact information) is securely stored. We will neither share it nor sell it to any third party. We will use your credit card number only to process your payment for this transaction. It is never stored on our website.
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