To become a member please print out this form and mail it along with a check for $25.00 to:

LAURELTON ART SOCIETY
P.O. Box 1425
Brick, NJ  08723


Name:

Street Address:

City, State, Zip:

Telephone #:

What media do you work in?

MEMBERSHIP DUES - JANUARY 1 THROUGH DECEMBER 31

(       ) Individual Membership $25.00
(       ) Student membership ( Ages up to 18) $5.00
(       ) Business Membership $25.00

Please indicate if you are qualified to:     Teach   ________       Lecture   ________    Demonstrate    ________

Please indicate if you are interested in exhibiting at Brick Hospital   Yes____        No_____
Would you be interested in volunteering in any of the following areas?
(       )Brick Hospital Gallery (       )Planning Committee - Annual Dinner
(       )Refreshment Committee for Monthly Meetings (       )Planning Committee - Trips
(       )Administrative Help - Membership (       )Planning Committee - Workshops
(       )T-Shirt Project (       )Planning Committee - Exhibits
(       )Scrap Book / Historian
Comments, Suggestions, Special Needs:



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