Washington Pavilion of Arts and Sciences Membership Form

Please complete the following form and hit "submit" at the end.

For information, call (605) 367-6000, or e-mail info@washingtonpavilion.org

*Name
Second Adult Name
*Address
*City
State Select your state.
*Zip Code
Number of children or grandchildren under 18 Household, Household Plus members only
*Phone Number
E-mail address
Select Type
	Gift Membership
	Mail membership to Giver?
Name of Giver
Address
City
State
Phone
Please accept my additional donation
For renewing members only, subtract $5 for Basic levels if primary member is a Senior (62+) or full-time student. One discount per membership
*Total
Please Charge My:
*Account Number
*Expiration Date