If you prefer to download a Word .doc of this form rather than printing from this webpage, click the file above.

The Artists Workshop, Inc.

Membership Request Form

Individual $35.00 - Family $45.00

Fill in the blanks:

Last Name______________________________First Name/Initial__________________________

PRIMARY ADDRESS_______________________________________________________________

Local Address Apt______Bldg. No.______Town__________________________ Zip____________________

Phone No._________________________________Cell______________________________________

e-Mail___________________________________________

Previously a Member? (circle) 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 with check to:

ARTISTS’ WORKSHOP, INC.

Registrar P.O. Box 1194

New Smyrna Beach, Fl. 32170-1194