Long Beach Museum of Art Membership Form

First Name: * Last Name: *

Street Address:

City: State: Zip code:

email address: *

* Required

Shipping Address same as Billing Address

First Name: Last Name:

Street Address:

City: State: Zip code:

Please choose a membership level: *

• Student/Educator - $40/year
• Individual - $50/year
• Family - $75/year
• Patron - $150/year
• Sponsor - $500/year
• Director's Circle - $1,000/year
• Collector's Circle - $1,500/year
• President's Circle - $2,500/year
• Milbank Philanthropic Circle - $5,000/year

Membership renewal

Gift membership

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* Required