Membership Order Form

1. You print out and mail this form with a check or money order to:

   The Folk Art Society of America
   Box 17041
   Richmond, VA USA 23226
   (804) 285-4532.
   1 (800) 527-FOLK (3655)

2. Or you can use our secure-server with Visa or MasterCard.

NAME___________________________________________________

ADDRESS __________________________________________________

CITY, STATE, ZIP _____________________________________________

TELEPHONE ________________________________________________

Email address _______________________________________________

Master Card/Visa# __________________________________________

EXP. DATE _________________________________________________

SIGNATURE ________________________________________________

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MEMBERSHIPS:

Membership includes free subscription to the Folk Art Messenger and discounts on books!

_____ Gold Star Membership = $1,000 or more
_____ Silver Star Membership = $ 500
_____ Bronze Start Membership = $ 250
_____ Contributing Membership = $ 100
_____ Family Membership = $ 50
_____ Individual Membership = $ 35
_____ Foreign Membership = $ 60 (US dollars only)
_____ Gift Membership = $35

Total enclosed for membership: _________________________________

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Folk Art Society of America
P.O. Box 17041, Richmond, VA 23226
800-527-FOLK (3655)
For more info: fasa@folkart.org
http://www.folkart.org/