TVIA Board of Arts
CAC Annual Membership Contribution

Date:  ____________________

Amount Paid:

     __________

Name: __________________________________

Check membership type:
  • Individual  ($15-$25)
Address:_________________________________

 
  • *Family  ($26-$45)
               _________________________________
  • Business  ($46-$75)
Phone:   ______________________

 
  • Corporate  ($76-$200)
Email:___________________________________
  • Sustaining  ($201-$1000)

  • Patron of the Arts (over $1000)
  *Families:  List immediate family members

 
  • Temporary ($1/week)
  ___________________________________________________

  ____________________________________________________
Return this form with your contribution to:  The Creative Arts Center, P.O. Box 1164, Eureka, MT  59917
THANK YOU for your donation!!
date in
index

 
db
MCF Rev. 11/08
 
 
 
 
 
 

TVIA Board of Arts
CAC Annual Membership Contribution

Date:  ____________________

Amount Paid:

     __________

Name: __________________________________

Check membership type:
  • Individual  ($15-$25)
Address:_________________________________

 
  • *Family  ($26-$45)
               _________________________________
  • Business  ($46-$75)
Phone:   ______________________

 
  • Corporate  ($76-$200)
Email:___________________________________
  • Sustaining  ($201-$1000)

  • Patron of the Arts (over $1000)
  *Families:  List immediate family members

 
  • Temporary ($1/week)
  ___________________________________________________

  ____________________________________________________


Return this form with your contribution to:  The Creative Arts Center, P.O. Box 1164, Eureka, MT  59917
THANK YOU for your donation!!
date in
index

 
db
MCF Rev. 11/08