Membership Application CSA Membership Application "*" indicates required fields Please read the membership guidelines before filling out this application.Are you renewing your membership?* Yes No Are you under 18?* Yes No Name* First Last Email* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Mobile PhoneWebsite Facebook Link Instagram Link Medium*Please list the mediums in which you workArtist StatementDescribe Your ProcessBe specific, examples materials used, acrylic vrs oil paints, did you cut your gem stones or if collage, are they your photos?DimensionsThe approximate dimensions of a typical piece of your workShows / Exhibit HistoryGallery ParticipationBusiness NameBusiness PhoneCorrales Business LicenseState of New Mexico CRS #State of New Mexico CRS #*Please upload 8 images that will be used in your artist profile. The filenames should be in the format [lastname]_[medium]_NNN.jpg where NNN is a number 1 through 8.Eight Artwork Images* Drop files here or Select files Accepted file types: jpg, gif, png, jpeg, Max. file size: 1 MB, Max. files: 8. Images must be under 1MB in size; longest side sized at 1200 pixels max.Rules Agreement* Agreed and Signed I have read the MEMBERSHIP RULES and agree to abide by them. Failure to do so may result in removal from CSA. I agree to hold harmless CSA, the Village of Corrales, or its approved delegates for any losses, thefts, damages or injuries that may occur during my participation, including set‐up and tear‐down, at any CSA event. I also certify that I am the sole proprietor of all rights in and to the work to be exhibited at CSA events. The work is wholly original and not derived from a pre‐existing work and was my creation. Works do not infringe any rights, copyrights, trademark rights, rights of publicity, or proprietary rights of any other individual or entity. Checking this box will affirm my agreement to this statement and represent my signature.Today's Date MM slash DD slash YYYY Corrales Society of Artists Membership Fee Price: Corrales Society of Artists Membership Fee Price: Total Credit Card Cardholder Name Card Details PhoneThis field is for validation purposes and should be left unchanged.
