Please Fill Out Form Pay Online or Mail in Payment Fields marked with an * are required Individual Artist Membership Individual Artist - Annual Membership Form Member Status * New Member Renewing Member Divider Copy Live, Work, Exhibited, or Performed * I live in Bristol or Warren, RI I work in Bristol or Warren, RI I both live and work in Bristol or Warren, RI Tell us where you work in Bristol or Warren (if it applies) Please tell us where your artwork has been exhibited or where you have performed within the past two years (if applicable) Divider Payment Pay Online Pay by Mail Divider Copy What type of artist are you? (Painter, Oil Painter, Mixed Media, Sculptor, Dancer, Storyteller, etc.) * First Name * Last Name * Email * Address * City * State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington DC ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST ARMED FORCES AMERICA (EXCEPT CANADA) ARMED FORCES PACIFIC Zip Phone * Website Social Media Handle(s) File Upload * Select Files Cancel Upload:a headshot or artist likenessimages of your work Divider Copy Copy If you are a human seeing this field, please leave it empty. DONATE TODAY! Mail In your Payment Please make your Check payable to: “ArtNight Bristol Warren” IN ANY AMOUNT USD and Mail To: Art Night Bristol Warren, P.O. Box 194 Warren, RI 02885