Powell River Council for Arts, Culture & Heritage

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Updated December 15, 2011

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Culture Dance Drama Film/Video Heritage Literature Music Visual

Powell River Arts' Council Membership Application

September 1– August 31

To become a member, please complete the form below and mail a cheque in the appropriate amount to

Powell River Council for Arts, Culture & Heritage
c/o The Patricia Theatre
5848 Ash Avenue, Powell River BC V8A 4R6

You will be contacted to confirm membership and receipt of payment; a formal receipt will be issued upon request.

MEMBERSHIP DETAILS

Name and address of person or organization:

Email:

Phone Number(s)

CATEGORY OF MEMBERSHIP - please select one
Groups:

Small: up to 20 members - $25

Large: over 20 members - $40

Business - $40

Patrons / Sponsors - Donation

Discipline (select one or more)

Number of Members in Organization:

Culture/Heritage

Dance

Drama

Film/Video

Comments or Suggestions:

Website:

Representative (if applicable)

Literature

Music

Visual Arts

Other

Include on Members’ page

Individual - $15

Yes

No

Clicking the submit button will take you to a page to enter an anti-spam word. You will then be directed to a confirmation page that and an email will be sent with the information submitted.

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