FIA Membership Form PAYPAL

Please use this form to apply for membership or to renew yearly dues via Paypal. Dues are $15 for regular members and $10 for student members. Dues can be paid electronically via PayPal or by check.

For questions or comments regarding paying dues to FIA, contact treasurer Michael Byington c/o Friends in Art712 s. Kansas Ave suite 410 Topeka KS 66603
treasurer@friendsinart.org

Name Name First Last
Email
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone
Do you have an existing membership?

Do you have an existing membership? Renew my existing membership I want to create a new membership
Are you a student interested in the FIA yearly scholarship and can we contact you?

Are you a student interested in the FIA yearly scholarship and can we contact you? Yes No
Please tell us more about your interestes: Check all that apply:

Please tell us more about your interestes: Check all that apply: Music/musician Voice Visual/graphic art Dance Literary arts and writing Theater and performing arts Access to arts Music therapy Other
How would you like to pay?

How would you like to pay? Pay online via Paypal Pay by check
Please choose a membership type (Paypal Payment)

Please choose a membership type (Paypal Payment) Regular Membership Student Membership
Please choose a membership type (Check Payment)

Please choose a membership type (Check Payment) Regular Membership Student Membership