PRINT THIS FORM AND MAIL WITH PAYMENT!

Alliance of Professional Tattooists
Membership Application
Autoclave Make and Model #:
 This box is for office use.

Please Print Clearly!


Name:
Email Address:


Home Address
(Street, City, State, Zip):

 

Home Phone:
Business Name:
Business Website:
Business Address
(Street, City, State, Zip):

Business Phone:

Fax Number:

Send my mail to: Home Business

Check this box to include your company information on the membership listing on the website

Please check the membership category you are applying for:
Click Here to Review Membership categories

Patron Supporter Cosmetic Tattooist
(Please fill out Section B below)
Associate Non-Artist
(Please fill out Section A below) 		Associate Artist
(Please fill out Section A below) 		Professional
(Please fill out Section B below)


Enclosed is my check money order credit card#
amount enclosed expiration date
ccv#
(last three digits on backside of card in signature block)
Billing Address: Home Business


Section A ~ Sponsor (for Associate Non-Artists and Associate Tattooists Only)

Artist's Name:
Years of Experience:
Business Address
(Street, City, State, Zip):

Business Phone:
Business Fax:


Section B ~ Trade References (for Professional Members only).

1) Business Name, Address (Street, City, State, Zip), Phone and Fax
2) Business Name, Address (Street, City, State, Zip), Phone and Fax
3) Business Name, Address (Street, City, State, Zip), Phone and Fax


YOU CAN EMAIL THIS FORM BY FILLING IT OUT
COPY AND PASTE IN BODY OF EMAIL OR...
PRINT THIS FORM AND MAIL WITH PAYMENT TO:
Alliance of Professional Tattooists
215 West 18th. Street, Suite 210
Kansas City, Missouri 64108
Office 816-979-1300
Fax 816-979-1310


This application process takes about two weeks. If you have any questions while you wait,
please call the home office at 816-979-1300