Holualoa Foundation for Arts and Culture
Donkey Mill Art Center

Membership Form

Please print, fill out, and mail in form to:
Donkey Mill Art Center
78-6670 Mamalahoa Hwy.
Holualoa, HI 96725
□ Student / Sr. Citizen $15/year □ Individual $25/year □ Family $45/year □ Sonsor / Business $100/year
□Associate $500/year □ Partner $1,000/year □ Life Member $10,000/year

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NAME (PLEASE PRINT)

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E-mail Address

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ADDRESS

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CITY STATE POSTAL CODE

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PHONE (DAY)

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PHONE (EVENING)

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FAX

 Payment Method:
□ Check
□ Credit Card
Please charge my:
□ Visa □ MasterCard □ American Express

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CARDHOLDER’S NAME (AS IT APPEARS ON CARD)

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CARD #

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EXPIRATION DATE


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SIGNATURE

I wish to volunteer for the following committees:
□ Aministration □ Building and Grounds □ Fund Raising □ Programs
I am available on:
□ Days □ Evenings □ Weekends