Become a Member
Please fill out and print the form
.
Name:
Address:
City:
State:
Zip:
Phone:
Email:
Annual Membership (check one):
$30 Friend
$50 Family
$100 Angel
$250 Patron
$1000+ Benefactor
Other $
Please send your form and check to the address below. Make checks payable to:
Confluence Gallery
Confluence Gallery
104 Glover Street
Post Office Box 716
Twisp, WA 98856
Thank You... for your generous 501(c)(3) tax deductible contribution.
