Membership Form

Please fill out all required fields.

* Required Fields

Enamelist Society Membership Form
*Name:
Company:
*Address:
*City:
*State (If you're outside the US or Canada please select AL and make a note in the comments box):
*Zip:
Country:
*Email Address:
Website:
Phone Number:
*Are you renewing a previous membership?:
How did you hear about us?:
Do you want to receive email news?:
Membership Categories (Select one, price listed is per year)
To join as a student member, you must be pursuing an art degree at an accredited university. You also need to provide the name of the University and your instructor(s).
Student Membership receiving an electronic copy of newsletter:	$20.00
Student Membership receiving a hard copy of newsletter:	$25.00
University or Institution:
Instructor(s):
Regular Membership Fees
I have not been a member of The Enamelist Society before and would like to receive the one-time $10 membership discount (excludes Student Memberships).:
Basic Membership (individual or family) includes reduced fees for conferences, workshope, exhibition entries, and electronic copy of newsletter:	$55.00
Basic Membership (individual or family) includes reduces fees for conferences, workshops, exhibition entries and hard copy of newsletter:	$60.00
Supporting Membership includes basic membership benefits plus an exhibition CD or catalog:	$95.00
Sustaining Membership includes basic membership benefits plus a catalog or CD from past exhibitions:	$140.00
Sponsoring Membership (corporate or individual) includes sustaining membership benefits plus a free display ad in the newsletter.:	$260.00
Additional Contribution:
For International Members: A $12.00 fee will be added for shipping on hard-copies of newsletters and CDs.
I would like to pay for two years of membership (The Enamelist Society will double your payment):
* Payment Method:
Accountholder Information - must match billing information.
First Name:
Last Name:
Credit Card
Card Nbr:	**Numbers only
Exp Date:	/
CVV:	What is this?
Billing Address - must match billing information.
Street:
City:
State, Zip:
Country:
Billing Email:
Questions or Comments:
*Authentication:
*7 + 9 =	Enter the correct answer to the math question.
Please click the Send button only once.