Date:______________________
Name:_______________________________________________________________
Address: _____________________________________________________________
____________________________________________________________________
E mail:_________________________________*
Phone: ________________________________
Web Site:______________________________
Medium:______________________________________________________________
I am interested in serving on The Arts Council board:
Yes ______ No _____
Would you like to receive e-mail from us offering information on arts and cultural news and events of which you may be interested?_______________
Enclose a check for $30 & Mail to The Arts Council of the Blue Ridge
20 East Church Avenue
Roanoke, VA 24011
Phone (540) 342-5790
Fax (540) 342-5720
www.theartscouncil.org
* The Arts Council of the Blue Ridge will not sell, trade, or rent the personal information you provide to The Council. The Council may share your e-mail address with other arts and cultural member organizations whose services and products might be of interest to you.
09/2005