Ozquilt Network 2020 Membership Form

Ozquilt Network Membership Form 2020
The membership year runs from 1 January-31 December 2020. All new and renewing members must complete an membership form regardless of method of payment.
Contact Details
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Post CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Status*

RenewalNew Member
Check any information you DO NOT PERMIT Ozquilt Network to publish to other members

NameStreetSuburb/PostcodePhoneEmail
Website
Blog
Facebook Artist Page
I request official notices (eg notice of AGM) by e-mail only.*

YesNo
Membership Fee
Membership Fee*

Full member A$40Student A$20
Payment by*

Direct Deposit/EFTCredit CardCheque/Money Order
Payment by Credit Card
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OZQN Full membership 2020$40.00AUD

OZQN Student membership 2020$20.00AUD

Total $0.00AUD
OZQN PREFERS PAYMENT BY DIRECT DEPOSIT BSB:033 602 Acct#:13 6213
(Please include your name and the letters “MBS” in transaction description).

Payment may also be made by:
- credit card (via PayPal): no PayPal account required; OR
- cheque payable to Ozquilt Network Inc and mailed to PO Box 753 WANGARATTA VIC 3677.
Supporting Information
Age Range*

18-2930-3940-4950-6970+Not specified
Arts Practice*

Textile or Quilt Artist - ExperiencedTextile or Quilt Artist - DevelopingArtist, non-textileArt ConsultantArts related business/workerArt StudentTutor/LecturerWriterCuratorOther
Many volunteers work together to make Ozquilt Network happen. Are you willing to assist in some way (eg exhibitions, functions, subcommittees, working parties)?*

YesNo
If yes, are there any special skills that you have that might be helpful to Ozquilt Network?
New Members: How did you hear about Ozquilt Network?
Comments
By submitting this form, I agree to be bound by the rules of Ozquilt Network Inc.
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Ozquilt Network Membership Form 2020