Heliconian Membership Application
Membership in the Club includes professionals in the arts, supporters and advocates. Please fill out this form with information that could be included in the Club Directory upon acceptance (information is shared within Club Membership)
First Name *
Your answer
Last Name *
Your answer
Title
Membership Type *
Required
Phone number(s): (main number required- enter first, additional numbers optional). *
Your answer
Email *
Your answer
Website
Your answer
Street Address *
Your answer
City *
Your answer
Province (and Country if not Canada) *
Your answer
Postal Code *
Your answer
Current Occupation/Vocation *
Your answer
In what capacity are you engaged in the arts? (check all that apply) *
What is your primary artistic focus? *
Required
Additional Areas of Interest- if any (check all that apply)
Education/Training/Experience *
Your answer
Why do you wish to join the Heliconian Club? *
Your answer
As a volunteer, which skills may you be interested in sharing or developing via Club involvement? (Please check possibilities)
Club membership requires the sponsorship of two current members
If you know one or two current members, please list their name(s) below. If not, we are happy to assist in connecting you with current members to act as sponsors.
Name of potential first sponsor
Your answer
Name of potential second sponsor
Your answer
No Club Member contact?
Verification/Signature *
Required
Submission Date *
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