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

Day

Month

Year

Multi-line address

Country/Region

Address

City

Zip / Postal code

Phone

How did you hear about DRAC?

Your bio

Maximum 800 characters

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?

Maximum 800 characters

Upload up to 8 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.

Please enter information about your artworks: Title, medium (eg Oil on canvas) and size in cm x cm (width x height)

Your website URL

This will be displayed in your member profile

Your Facebook username

This will be displayed in your member profile

Your Instagram username

This will be displayed in your member profile

Other social media username

This will be displayed in your member profile

I have read and understand the Membership Guidelines.