To become a member please print out this form and mail both the form and a check payable to "Laurelton Art Society" to:

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



MEMBERSHIP DUES
JANUARY 1, 2014 through DECEMBER 31, 2014
 

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

Date: ______________________________

Name: ____________________________________________________________

Street Address: _____________________________________________________

City, State, Zip: _____________________________________________________

Telephone: ________________________________________________________

E-mail Address: ____________________________________________________

Art media you work in: _______________________________________________

Please indicate if you are qualified to:

______ Teach      ______ Lecture      ______ Demonstrate
 
Please indicate if you are interested in volunteering in any of the following areas?
(   ) LAS Grant Committee (   ) Exhibits Committee
(   ) April "Festival in Art" (   ) Society Photographer
(   ) Hospitality Committee (   ) Annual Dinner Committee
(   ) Scrap Book / Historian (   ) Annual Trips Committee
(   ) Membership Committee (   ) Program Committee
 
Comments, Suggestions, Special Needs: