OCPAG Membership Application

OCPAG Membership Application
Membership Categories Individual ($25) Family ($35) Patron of the Arts ($50 or more) Supporting Patron ($100 or more) Benefactor ($250 or more) Business ($50) Business Patron ($100) Business Benefactor ($250 or more) I'm interested in serving on the board or as a volunteer helper My suggestions for programs and activities are attached Please check all the arts events you are interested in Classical music Celtic Country & Western Opera Dixieland Mainstream Jazz Ballet / Dance Poetry Contact Information Name Address City, State, Zip E-mail Phone
Payment Check Cash Money Order Credit Card Visa MasterCard Card Number ExpirationDate Signature ____________________________________
Thank you for being a valued supporter of Ouray County Performing Arts Guild! Please mail this form with your payment to: OCPAG, P.O. Box 14, Ouray, CO 81427