Membership Application Form

To ensure we have the correct contact details for you, please complete this form.Please keep a copy for your records.

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Email *

Membership £12.00pa

Due on 1st January (Membership runs 1st Jan to 31st Dec).

You can join at any point through the year.

Membership benefits include attend HAN meetings, first notification of exhibiting opportunities, create

your own artist’s page and art events on HAN website.

Applicant Personal Details:

Name *
Address *
Postcode *
Home Telephone number
Mobile Number
Parent's name if under 18

Emergency Contact Details:

Please insert the information below to indicate the person(s) who should be contacted in the event of an

incident/accident.

Contact name:

 *

Emergency Contact Number:

 *

Relationship to Member

Artist Details:

Describe your Art style

 *

Your Website Details

Public Liability

Do you have Public Liability Insurance

 *

Does the policy cover shows/work away from home?

Clear selection

Policy Number

Policy provider

Policy Expiry Date

MM
/
DD
/
YYYY

New member or Renewal?

 *
Required
Signed *
Date *
MM
/
DD
/
YYYY

By completing this application form you give us permission to hold and process your data in connection with your HAN membership.

MEMBERSHIP BANK PAYMENT DETAILS:
Lloyds Bank

Account Name: Hailsham Artists Network

Account Number: 71985862

Sort Code: 30-98-97

Please use MEMB followed by your name as a reference

If you require any further information or clarification regarding this application, please contact:

Valerie Evans

Organisation position: Membership Secretary

Email address: info.hailshamartists@gmail.com


Any queries about payment: finance.hailshamartistsnetwork@gmail.com.


A copy of your responses will be emailed to the address you provided.
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