CITIZENS INTERESTED IN ARTS, INC. 

MEMBERSHIP FORM

To join Citizens Interested in Arts, Inc. 
please print this membership form and send with your check to:

Coleen Werner
2468 Bay Isle Court
Weston, FL 33327-1410.

Name ____________________________________

 
Address ____________________________________

 
City/State/Zip ____________________________________

 
Telephone ____________________________________

 
FAX ____________________________________

 
E-Mail ____________________________________
Recommended
By CIA Member		  

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Please List
Participation In
Other Arts
Organizations		  

____________________________________
 

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Thank You!

$125.00 per membership
All contributions are tax deductible

Please make checks payable to:
Citizens Interested in Arts, Inc.
A 501�3 non-profit organization