Membership Type: (Please check one)
   New        Renewal        Renewal (after lapse)
   Change of Membership Information
 
U.S. Memberships:
    Regular Membership ($40)
    Associate Membership ($25)
          (Must be shared with a Regular Member)
    Corporate Membership ($130)
    Lifetime Membership ($800)
 
Foreign Memberships:
    Regular, North American ($45)
    Regular, Other Foreign ($50)
    Associate Membership ($25)
          (Must be shared with a Regular Member)
    Lifetime Membership ($800)
 
Important: Membership fees must be made in U.S. funds.

Name:

Name for ID Badge (if different from above):

Company / Studio Name (if applicable)

 
Mailing Address: (2 lines)



City:

State/Province:
Choose State/Province Other/International Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Postal/Zip Code:

Country:

 
Phone #

Fax #

E-mail:

Home page (www):

 

Categories (Please indicate three for your directory listing)
- selection 1 - Agent Amateur Artist Art Show Management Art Collector Art Director Auctioneer Critic Computer Artist Cartoon/Comic Artist Editor Fabric Artist Graphic Designer Illustrator Interest in Art Jeweler Painter Photographer Press Professional Artist Publisher Sculptor Semi-Pro Artist Student Writer

- selection 2 - Agent Amateur Artist Art Show Management Art Collector Art Director Auctioneer Critic Computer Artist Cartoon/Comic Artist Editor Fabric Artist Graphic Designer Illustrator Interest in Art Jeweler Painter Photographer Press Professional Artist Publisher Sculptor Semi-Pro Artist Student Writer

- selection 3 - no selection Agent Amateur Artist Art Show Management Art Collector Art Director Auctioneer Critic Computer Artist Cartoon/Comic Artist Editor Fabric Artist Graphic Designer Illustrator Interest in Art Jeweler Painter Photographer Press Professional Artist Publisher Sculptor Semi-Pro Artist Student Writer
 
Would you like your mailing address listed?
In order to recieve art show and contest mailings, your address must be listed.
Yes    No
 
Would you like your phone number listed?
Yes    No
 
Would you like your email & web address listed?
Yes    No

Would you like to receive art show/contest flyers and related material through the mail?   In order to recieve art show and contest mailings, your address must be listed.
Yes    No

I am interested in becoming more involved in ASFA. I would like to volunteer my time assisting in the following areas:
 
Chesley Awards Comittee
Producing content for the ASFA Quarterly
Assisting at the ASFA table at Conventions
Helping out in the Hospitality Suite at Worldcons
Designing flyers for events and meetings
Providing Art for ASFA publications and forms
Internet Grievance Committee
Convention Grievance Committee
Providing Advice to new Artists
Other:
 
I am not interested in volunteering at this time.

The Association of Science Fiction and Fantasy Artists (ASFA) is a private, non-profit educational association, and as such relies heavily on the support of its member and the community. Your donations greatly help to cover our operating expenses and ensure our continued survival. ASFA is exempt from Federal taxation under section 501(c)(3) of the Internal Revenue Code which means contributions receive the maximum deductibility permitted under Federal law.
 
Would you like to make a donation at this time?
Yes    No
 
If so, would you like to receive written acknowledgement of your donation for IRS purposes?
Yes    No
 
Please indicate amount of donation enclosed: {If applicable}
$