Bakery Membership ApplicationPlease fill out the form below. Name * First Name Last Name Date * Date of submitted app. MM DD YYYY Email * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Website Or instagram http:// What membership type are you applying for? * Select one Core Membership Student Membership Intern / Volunteer Tell us a little bit about yourself? * How do you plan on using the facilities at the Bakery? * Have you rented our facilities in the past? * Yes No Do you have experience using Epson large format printers? * Yes No Do you have experience using Epson flatbed scanners? * Yes No Do you have experience developing B&W film? * Yes No Do you have experience working in a darkroom? Yes No Do you have experience using a Flextight X1 professional scanner? * Yes No List two references Please provide contact info for two references below. Reference one * Relation Name First Name Last Name Phone (###) ### #### Email Reference two * Relation Name First Name Last Name Phone (###) ### #### Email Thank you! We will review your app and get back to you a.s.a.p.
