La Loba Creations  

Membership Form

 artsy56@aol.com 607.772.9711 


 


 

 

 

 

 

 

The Art Barn Membership Form

Please check one membership level and complete all other fields including credit card information. You may fill out the form, print it, and mail it in with your payment.
Please call La Loba Creations at 607-772-9711 or email Yvonne if you have questions.

"Arty": One month (4 weeks) Membership: $75 / 4 week session
  Adult accompanied by a child: $100
 
"Artiste": Three months (12 weeks) Membership: $175 / 12 week session
Adult accompanied by a child: $250
 
"Artarama": Six months (24 weeks) Membership: $300 / 24 week session
Adult accompanied by a child: $375
 
"Artrageous": One year (52 weeks) Membership $500 / full year
Adult accompanied by a child: $600
 
Name Address
   
City State- ZIP
      
Phone (area code first) Email
  Cell  
Credit Card Name on Card
   
Card Number (no dashes) Expiration Date
      
I am sending a check with this form. Please make checks payable to:
La Loba Creations, and mail to
4011 Saddlemire Road
Binghamton, New York 13903
Total Enclosed
 

back to open studio