OhioDance Membership Signup Form

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You can also join using your credit card!

Use the following link:http://www.acteva.com/go/ohiodance

New	Renewal
Name
Organization
Address
City/State/Zip
Phone
Fax
E-mail
Comments

Individual	$35
Individual	$65
Student	$20
Joint membership: OhioDance and Ohio Citizens for the Arts	$50
Joint membership: OhioDance and Ohio Alliance for Arts Education	$50
Joint membership: OhioDance, Ohio Citizens for the Arts, and Ohio Alliance for Arts Education	$70

Supporter	$50-74
Sponsor	$75-99
Donor	$100-249
Benefactor	$250+

Organization	$50
Organization Sponsoring	$100
Organization Sustaining	$500

I would like a discount coupon for a magazine subscription to: Dance Teacher Pointe Dance Spirit Dance Magazine
Confirmation and invoice will be sent via postal mail

Download a printable version of this form here, if you prefer (Word format—26KB).

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update 5/18/04

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