Collectors of Wood Art--Membership Form

Please make your check payable to the Collectors of Wood Art and send to Collectors of Wood Art, P.O. Box 491973, Los Angeles, CA 90049

Which membership level?

	Guarantor--$2500		Founder--$1000		Benefactor--$500		Patron--$250		Family--$125
	Basic--$75		Gallery --$200		Museum --$75		Newsletter Subscription (only)--$25

Do you identify yourself as: (Please check as many as are appropriate)

Collector

Curator

Dealer

Artist

Other (specify)

How do you wish to be listed in the Membership and Resource Directory?

Name, Address, Phone and eMail

Name Only

No directory listing

Are you willing to have members visit your collection?

Yes

No

Yes, if though a coordinator

CWA occasionally makes its mailing list (without e-mail addresses) available to museums, galleries, artists and others promoting studio wood art.  If you prefer NOT to receive such mailings please check here ______

Please use this form for any change of address and send to Collectors of Wood Art, P.O. Box 491973, Los Angeles, CA 90049

The Collectors of Wood Art is a 501(c)(3) organization. The estimated value of goods and services received is $25
for Basic through Patron, Gallery and Museum Memberships; $50 for Benefactor and above.

Ed. 03/03/07 WS