CULTURAL COUNCIL OF CORTLAND COUNTY
                              2010 MEMBERSHIP FORM

    NAME*__________________________________________________
    *Please write name(s) as you wish it to appear on our published membership roll

    ADDRESS____________________________________________
    CITY_______________________STATE_____ZIP____________
    EMAIL______________________________________________
    Check Membership Level:                ___Member ($30)
                                           ___Supporter ($50)                                        
                                           ___Sponsor ($75)
                                           ___Friend/Corporate ($100)
                                           ___Angel ($500)

    Members receive a 10% discount on Auction Items and works from the Cortland  Arts
    Trail
    Mail form to:  Cultural Council of Cortland County, 9 N Main St., Cortland, NY  13045