Page 96

Winter/Spring 2015

Membership Form

1 Year

94

Yes! I want to be a Member of The Studio Museum in Harlem.

Mr.

Ms.

Mrs.

Other

Renewal Gift

Name of membership holder

MEMBERSHIP Donor $500 Associate $250

Name of additional member (Family/Partner level members and above)

Supporter $125 Family/Partner $75 Individual $50

Address

Student $25* Senior $25* City

State

Zip

STUDIO SOCIETY Studio Society $1500 Work Phone

Home Phone

*(Student/Senior Membership will not be processed without a copy of a valid ID) American Express

Email Address

MasterCard Visa

Please do not make my name, address and other information available to third-party providers.

I have enclosed my check

Please list as Anonymous.

(make check payable to The Studio Museum in Harlem) Name of cardholder

Address

Âť MAIL TO The Studio Museum in Harlem

Address

State

144 W. 125th St. New York, NY 10027

Work Phone

Home Phone

Card Number

Expiration Date

Signature

Zip

Profile for The Studio Museum in Harlem

Studio magazine (Winter/Spring 2015)  

Studio is the Studio Museum in Harlem's magazine, published twice a year and distributed free of charge to museum members and visitors. In a...

Studio magazine (Winter/Spring 2015)  

Studio is the Studio Museum in Harlem's magazine, published twice a year and distributed free of charge to museum members and visitors. In a...