New & Renewing Membership Form

Please complete the electronic form below or click here for a printable form.

Your membership is an on-going commitment to the creative life in your community and supports efforts to provide a home for exploring and appreciating the visual arts in our community through exhibition and related programs.

My Membership is:

New Renewal
Membership Level
Individual Member( $45.00 USD for each year .)
Family( $60.00 USD for each year .)
Blue Line Artist( $70.00 USD for each year .)
Contributor( $100.00 USD for each year .)
Patron( $250.00 USD for each year .)
Benefactor( $500.00 USD for each year .)
Blue Line Society( $1,000.00 USD for each year .)
Senior Individual( $40.00 USD for each year .)
Senior Blue Line Artist( $65.00 USD for each month .)
Name
First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number
- Area Code Phone Number
E-mail
Membership dues only cover 13% of Roseville Arts' expenses for exhibtis and programs. Any additional donation would be greatly appreciated.

* Seniors (ages 65+) are eligible for 10% off any membership level
Membership Amount $
Additional Donation $
Total Amount $
I would like to Pledge $
Monthly Quarterly
Should be Empty:

Roseville Arts! Blue Line Gallery | 405 Vernon St, Ste. 100, Roseville, CA 95678 | (916) 783-4117

New & Renewing Membership Form

Membership dues only cover 13% of Roseville Arts' expenses for exhibtis and programs. Any additional donation would be greatly appreciated.