Clone of Clone of Group/ Partnership organizations/ Family Level

AVA Dual Membership

Please fill out the following information to purchase an AVA Access Membership.
Full Name (Member 1)

First NameLast Name
Pronouns (Member 1)

He/Him/HisShe/Her/HersThey/Them/TheirsOther
Write In Pronouns
Email Address (Member 1)
example@example.com
Phone Number (Member 1)
Please enter a valid phone number.
Pseudonym/ Business name (Member 1)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Website/ social media (Member 1)
Visual Arts Involvement (Member 1)

ArtistsArt Enthusiast/DonorArt Collector
Artist Medium (select all that apply)

2D Mixed Media3D Mixed MediaAcrylic PaintClayColored PencilDigital ArtDrawingFiber/FabricGlassGraphiteInkJewelryMetalMuralOil PaintPastelsPhotographyPrintmakingSculptureStoneWatercolorWoodOther
Member #2

AVA Dual membership is for two members living or working under the same address. Please provide information for the additional member on your account.
Full Name (Member 2)

First NameLast Name
Email (Member 2) *must be different from Member 1
example@example.com
Phone Number (Member 2)
Please enter a valid phone number.
Website/ Social media (Member 2)
Visual Arts Involvement (Member 2)

ArtistsArt Enthusiast/DonorArt Collector
Artist Medium (Member 2)

2D Mixed Media3D Mixed MediaAcrylic PaintClayColored PencilDigital ArtDrawingFiber/FabricGlassGraphiteInkJewelryMetalMuralOil PaintPastelsPhotographyPrintmakingSculptureStoneWatercolorWoodOther
Please check the categories that best describe you OR your member partner

African American / BlackAsian / Asian AmericanHispanic or Latino / Latina / LatinxNative American / Alaska NativeMiddle Eastern / North AfricanNative Hawaiian / Pacific IslanderWhite / CaucasianMultiracial / Mixed EthnicityPrefer Not to AnswerOther
Age

Under 1818-6565+Prefer not to answer
Gender Identity

Prefer not to sayNon-ConformingNon-binaryMaleFemaleTwo-SpiritedOther
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Please note: This membership auto-renews annually—Cancel your membership anytime.

My Subscriptions

Dual Membership (auto-renews)

($115.00 for 1 year)

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AVA Dual Membership

Member #2

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