2003 MEMBERSHIP

Membership priviledges include participation in annual meetings; invitations to exhibitions, concerts and other events; free admission to all exhibits; and discounts on purchases.

__________ Individual ($40)

__________ Family ($50)

__________ Student or Senior Citizen ($30)

__________ Associate ($100)

__________ Donation

__________ Supporter ($1000)

__________ Sponsor ($2000)

__________ Patron ($5000)

__________ Benefactor ($10,000)

__________ Distinguished Benefactor ($25,000 and up)

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Print the application directly from your browser and mail the completed form along with your contribution to the address at the top of the screen. Please print the necessary information below.

Name

________________________________________________

Street address

________________________________________________

City/state/zip

________________________________________________

Telephone

________________________________________________

E-mail

________________________________________________

Signature

________________________________________________

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__________ Amount enclosed.

__________ Check number.
Please make check payable to UIMA.
Memberships and contributions are tax-deductible.
Tax exemption No. 23 718 6981

Thank you!
UIMA is grateful for the generosity of its patrons and contributors.

This form in Ukrainian - CP1251 ====>