Lake Wales Arts Center
Membership Application
| $5,000 Guardian Angel |
$500 Sponsor |
$75 Family |
| $2,000 Arts Angel |
$250 Patron |
$45 Individual |
| $1,000 Benefactor |
$100 Sustainer |
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| Please circle one: / Miss / Ms. / Mrs. / Mr. / Mr. & Mrs. / |
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Seasonal address (if applicable) |
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| Date at this address: |
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Please check if your company has a matching gift program. |
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| Please check if you do not wish the benefits of membership and would like to make a donation only. |
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| Visa/MasterCard # |
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Expiration Date |
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| Make checks payable to Lake Wales Arts Council. Print and complete form, then mail to: |
Lake Wales Arts Council, P.O. Box 608, Lake Wales, FL 33859-0608 |