Rogue Gallery Art Center

Application

This form is for those who wish to join as members, renew memberships, or become a corporate sponsor. Thank you for your support to the Rogue Gallery & Art Center — you play a key role in keeping the arts alive in the Rogue Valley.

Membership Form

Would you like to: * join as a new member
renew your membership
First Name: *
Last Name: *
Business Name:
Street Address: *
City: *
State: *
Zip: *
Home Phone: *
Work Phone:
Cell Phone:
Email Address: *
   
Member Level: *
Enter Amount: *
   
I am an artist: Yes No
   
I am interested in volunteering Yes No
   
I am interested in classes: Yes No
   
Would you like to include an additional gift? Yes No
Gift Amount:
I have included a gift in support of: Unrestricted Support
Endowment Fund
Scholarship Fund
Enter Vaidation Code: *
 

 

* Required

Rogue Gallery & Art Center is a 501(c)(3) non-profit organization. Your privacy is of utmost importance to us. We do not sell or give our donor list to other organizations. Thank you!

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Ignite the Mind, Stir the Soul, Open the Heart