MEMBERSHIP FORM FOR LOUISIANA PRESENTERS NETWORK Name _________________________________________ E-mail _______________________________________ Organization ________________________________________ Organization web site ___________________________________ Address ________________________________ ________________________________ City ___________________________________State _________Zip _________ Phone __________________________FAX ____________________________ For presenter members, membership dues are based on performing artist fees paid in latest fiscal year: $15,000 and under $ 50 $15,000-29,999 $ 75 $30,000-49,999 $100 $50,000-499,999 $150 $500,000 and over $250 **Arts Councils may pay the dues from the total of their presenter’s fees. For example—All presenters fees in your region equal $49,000. Dues = $100 in stead of the $75 dues for just the Arts Council. Presenters are listed separately as part of the Arts Council. Dues for performing artist members: In-state $ 30 Out-of-state $ 60 Dues for affiliates (artist management, service organizations, councils, etc.): In-state, non-voting $ 75 Out-of-state, non-voting $150 Student, non-voting (25 and under) $ 15 Make checks payable to: Louisiana Presenters Network Mail to: Louisiana Presenters Network 4030 Front Street, Suite B Winnsboro, LA 71295