Basic Membership Form

Basic Membership

Name on Credit Card*
First Last
Billing Address*
Street Address Address Line 2 City State ZIP Code
Email
Membership*
- Individual - $45
- Family - $65
Member's Name - If Different from Purchaser
First Last
Member's Address - If Different from Billing Address
Street Address Address Line 2 City State ZIP Code
Member's Age - If Under 18
Comments
This field is for validation purposes and should be left unchanged.

The Delaplaine Arts Center, Inc. is 501(c)(3) nonprofit organization, and all contributions are deductible to the fullest extent allowed by law. All donations are acknowledged. A copy of our current financial statement is available upon request by contacting the Development Office at 301-698-0656 x109. Documents and information submitted to the State of Maryland under the Charitable Solicitations Act are available for the cost of copying and postage. Tax ID #52-1481592.

Basic Membership

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