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HCAC Membership Form
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NAME
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BUSINESS NAME (If Applicable)
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ADDRESS
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CITY
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STATE
*
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ZIP CODE
*
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PHONE NUMBER
*
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EMAIL ADDRESS (Optional)
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MEMBERSHIP LEVEL
INDIVIDUAL MEMBERSHIP - $25
FAMILY MEMBERSHIP - $30
BUSINESS MEMBERSHIP - $60
CORPORATE MEMBERSHIP - $125
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PATRON LEVEL
BRONZE - $100 - $249
SILVER - $250 - $499
GOLD - $500 - $999
PLATINUM - $1000+
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PAYMENT METHOD
*
CASH
CHECK
CREDIT/DEBIT CARD
If you chose cash or check for your payment method, please mail your payment to: HCAC, P.O. Box 249, Bolivar, TN 38008. Checks should be made payable to Hardeman County Arts Council (HCAC)
If you chose credit/debit card for your payment method, an HCAC Representative will contact you to arrange payment via phone.
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