All members receive: Advance notice/discounted reservations (when applicable)
for events. Levels of membership include: Principal (1 Person) $40.
Art Deco Society of Los Angeles Annual Membership Application
Date____________________________ ____New Membership
____Renewal
____Gift
Member Information Primary Name (First, Last)____________________________________________________________________ Secondary Name (First, Last)_________________________________________________________________ Gift Membership only_______________________________________________________________________ Address____________________________________________________________________________________ City_____________________________________________ State______________ Zip___________________ Phone_________________________________________ Email______________________________________ Billing Information Payment: ____Visa
____Mastercard
____Check # (payable to ADSLA)
____Cash
Cardholder name___________________________________________________________________________ Card Number________________________________________ Expiration_____________ CVV2__________ Address (if different)_________________________________________________________________________ City______________________________________________ State______________ Zip_________________ Signature__________________________________________________________________________________ Level of Support (Per Year) ____ Exposition/Corporate ____ Exposition ____ Sustaining ____ Sponsoring ____ Household ____ Principal ____ Student (with valid ID) ____ Senior (over 65 with valid ID)
$1,000 $500 $175 $125 $60 $40 $25 $25
Please complete and mail to: Art Deco Society of Los Angeles P.O. Box 972 Hollywood, CA 90078 or Join online at www.ADSLA.org
The Art Deco Society of Los Angeles is a 501(c)(3) nonprofit organization dedicated to the preservation and awareness of Art Deco as a major influence on the 20th century and beyond. www.adsla.org 310-659-3326 Membership email:
[email protected] For ADSLA use: Received via________________________ Date entered________________________ Reward for_________________________
Membership form.indd 1
Credit Card Processed________________________________ Info taken by_______________________________________ Notes_____________________________________________
8/31/15 10:44 PM