Membership Application Form

Daylesford Regional Arts Co-operative

APPLICATION FOR MEMBERSHIP

Only residents of Hepburn Shire are eligible for membership

Do you currently reside in the Hepburn Shire?

Yes

First name

Last name

Date of birth

Country/Region

Address

City

Zip / Postal code

Email

Phone

Please indicate your field/fields of interest

How did you hear about DRAC?

Your bio

Upload artist profile image

Image must be at least 1000 px on the long side @ 72 dpi. Max file size 3 MB.

Do you have any special skills you could contribute to DRAC?

Upload 5 images of your artworks

Images must be at least 1000 px on the long side @ 72 dpi. Max file size 3 MB. Click HERE to see multiple uploaded files.

Your website URL

Your Facebook username

Your Instagram username

Other social media username

I have read and understand the Membership Guidelines.