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TEAM Membership Application Southeast Region

Fill out the information in this form. PRINT copy to send with dues to SE Region Treasurer (address below).
Use Tab Key Not Enter Key To Change Fields!    All Fields in Red Are Required

Region:

First Name:

Last Name:

Address:

City:

State:

Zip:

Telephone Number:

E-Mail Address:

Teacher: Yes / No     (Continued on Next Column)

Your Website Address (if Applicable)

ART EDUCATION (Schools, Teachers):

PROFESSIONAL or BUSINESS BACKGROUND(Companies and Dates):

ART ORGANIZATION AFFILIATIONS(include dates):

PREVIOUS EXHIBITIONS & JURIED SHOWS,

indicate Solo (S) Group (G) or Club (C):

COLLECTIONS (Public or Private):

CURRENTLY TEACHING AND WHERE:

How & from Whom did You hear about TEAM:

Edit carefully!  PRINT a copy to send in with dues and for yourself! Now click SUBMIT!   Welcome!

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