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Be a Member of the International Society of Assemblage and Collage Artists

This form provides a convenient way to join and renew online using your credit card.

Please select one

	I am a new member.
	I am renewing my membership.
	I was a member in the past and would like to rejoin.

$35 Individual
$50 Family


Contact Information

	Full Name (as it will appear on all membership records)

	Second Cardholder Full Name (as it will appear on all membership records for Household level and above)
Address
City
State
Zip
Daytime Phone
Evening Phone
Email


Payment
Credit Card Type
Credit Card Number
Expiration Date
Total Amount $



You may also pay securely by paypal.com - account = cecil@touchon.com
If you prefer to join by regular mail, you can print out this membership form and mail: The International Society of Assemblage and Collage Artists Attention: Cecil Touchon 6955 Pinon Street Fort Worth, Texas 76116 Checks Payable to Cecil Touchon The International Museum of Collage, Assemblage and Construction