Please type in all fields that apply, then print this form and send it along with your payment to (also make checks payable to):

Maple Grove Arts Council
P.O. Box 2009
Maple Grove, MN 55311

Name*
Address*
Address
City*
State*
Zip*
Home Phone*
Work Phone
Email
* = Required field
Membership Level (Select one)
Corporate $1,000 Patron $500 Sponsor $250 Donor $100 Family $50 Individual $25 Senior (55+) $15 Student (18 or younger) $15