ArtFusion Working Artist Renewals Working Artist Renewals Date Month Day Year Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Occupation* Phone*Email* Enter Email Confirm Email Please list any other art organziation to which you belong.Membership level* Working Artist $100 I am an ArtFusion 19464 instructor. I am intersted in serving on the following commitee(s):Please choose as many as you like. Working Artist Committee Fundraising Committee My skills include:Choose as many as apply. Computer/database Leadership Marketing Finance Event planning Grant writing Hospitality Would you be willing to gallery sit? Yes No Images of my work* By checking here, I agree, as a Working Artist of ArtFusion 19464, for my work to be used in promotional materials and advertising. Additional commentsCaptchaPlease enter the CAPTCHA code above.
