mail to:
The Parrish Art Museum
25 Job's Lane, Southampton, NY 11968
YES! I would like to become a member:
General Memberships
$25 Student
$25 Individual Senior
$50 Dual/Family Senior
$40 Individual
$45 Individual Artist
$65 Dual/Family
$125 Associate
$250 Sponsor
Business Memberships
$250 Sponsor
$500 Patron
$1,000 Benefactor
Parrish Council Memberships
$1,000 Parrish Council Gold
$2,500 Parrish Council Platinum
Art Club
$500 Art Club Member
Enclosed is a check for $ ____________
made payable to The Parrish Art Museum.
Please charge my:
__ Visa/Mastercard __ American Express
______________________________________________________
Account # Expiration date
______________________________________________________
Name
______________________________________________________
Second Name (Dual/Family and up)
______________________________________________________
Address
______________________________________________________
City State Zip
________________________________________________________
Telephone Other Telephone
________________________________________________________
Summer Address (if different)
________________________________________________________
City State Zip
________________________________________________________
Please mail to my summer address
________________________________________________________
(Dates) From: To:
e-mail address___________________________
