Robaba Palette Club- Membership Application

Membership Application

Robaba Palette Club

Membership Application

Thank you for your interest in becoming a member of the Robaba Palette Club.

Membership in the Robaba Palette Club is required for individuals who wish to purchase original paintings, commission portraits or custom artworks, enter into commercial agreements with Robaba Palette, or receive commissions from the sale of artworks.

To apply for membership, please complete the application form below and provide accurate and up-to-date information.

Submitting this application does not automatically grant membership.

Each application will be reviewed by the Robaba Palette Management Team, and applicants will be notified once a decision has been made.

Personal Information

First Name *

Middle Name (if applicable)

Last Name *

Pronouns

He/HimShe/HerThey/ThemOtherPrefer not to say

Residential Information

Where do you currently live?

Street Number *

Street Name *

Unit / Apartment / House Number (if applicable)

Postal / ZIP Code *

City *

Province / State *

Country *

Contact Information

Email Address *

Confirm Email Address *

Primary Phone Number *

Secondary Phone Number (Optional)

Social Media Information

To help us learn a little more about you, please provide one or two of your social media profiles.

Social Media Profile 1 – Required

Platform / Social Media Name *

Profile URL *

Social Media Profile 2 – Optional

Platform / Social Media Name

Profile URL

Tell Us More About Yourself

Please tell us a little about yourself, your interests, background, or connection to art.

About You *

Maximum: 100 words

Artwork Ownership

Do you currently own or possess an original artwork by Robaba Mohammadi?
*

YesNo

If yes, in what year did you receive or acquire the artwork?

Please upload a photograph of the artwork.

Required if you selected “Yes”.

Accepted file formats: JPG, JPEG, PNG

Maximum file size: 5 MB

Applicant Photo

Please upload a recent photo of yourself. *

To help us verify your identity and maintain an accurate membership record, please upload a recent, clear photo of yourself.

The photo will be kept as part of your membership record in the
Robaba Palette Club database and will be used for membership identification and administrative purposes.

Photo Upload *

Accepted file formats: JPG, JPEG, PNG

Recommended: A clear, recent photo showing your face.

Maximum file size: 5 MB

Applicant Declaration

I confirm that the information provided in this application is accurate and up to date. I understand that the information and photos submitted may be stored securely as part of my Robaba Palette Club membership record.

By submitting this application, I confirm that I have provided accurate information and understand that submission of this application does not automatically guarantee membership. My application will be reviewed by the Robaba Palette Management Team.