Membership Application

HEART OF MICHIGAN DECORATIVE ARTISTS MEMBERSHIP APPLICATION
AND DIRECTORY INFORMATION 

NAME_____________________________________________________________________________

                Last                                                  First                                      Spouse’s first name

ADDRESS________________________________CITY_____________________STATE______ZIP__

HOME-PH_______________WORK________________CELL________________FAX______________

EMAIL ADDRESS__________________________________________________BIRTHDAY_________

SOCIETY OF DECORATIVE PAINTERS MEMBERSHIP NUMBER _________New__Renewal_________

OTHER CHAPTERS TO WHICH YOU BELONG______________________________________________

PAINTING CERTIFICATION-MDA____CDA____ HOW LONG HAVE YOU PAINTED?_______________

ARE YOU A PAINTING TEACHER?_______WHERE?____________ARE YOU A STUDENT?_________

ARE YOU A SHOP OWNER?_______________NAME OF SHOP________________________________

PREFERRED PAINTING MEDIUM – Oil___Acrylic___ Watercolor___Fabric___Other________________

STYLE(S) OF PAINTING YOU ENJOY_____________________________________________________

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HOBBIES AND INTERESTS OTHER THAN PAINTING________________________________________

You must be a member of the National Society of Tole and Decorative Artists, Inc. to become a member of the Heart of Michigan Decorative Artists. The annual fee is $40.00 and you can obtain an online application at http://www.decorativepainters.com/

Please send your completed HOMDA application and $12 membership fee to :

Chris Keppel, 14810 Idylcrest, Lansing, MI 48906
After December 31, 2010, the membership fee is $20 for the 2011 year.