Artists' Workshop Inc. 

                     115 Canal Street

                       New Smyrna Beach, Fl 32168

                      386-424-9254

                      

 Membership Application:  Individual $35.00 - Family $45.00
 

Fill in the blanks:

Last Name: First Name/Initial:
PRIMARY ADDRESS:

Local Address 

Apt: Bldg. No.:
City: 
Zip: --
Phone No.:
e-Mail: Cell
Previously a Member?: Yes   No  
What year/s:  
   
   
   
I Paint                   Yes No  
I am interested in classes:      Yes   No  
I will Volunteer to be a Committee member: Yes No  
Officer: Yes No  
Areas of interest:
Signature: ____________________________________________________________

 

Please Print form and sign before mailing to

ARTISTS’ WORKSHOP, INC.

 Registar

P.O. Box 1194

New Smyrna Beach, Fl. 32170-1194