ARTISTS WITH HEART - MEMBERSHIP FORM
Print out and take with dues to next meeting or mail with check to:
(Check payable to Artists With Heart)
4950 Anthony Lane,
Pasadena, Texas 77505, USA
Phone/Fax: 281-998-1950
| Name: ____________________________________________ | Date: _________________________ |
| Street Address______________________________________________________________________ | |
| City/State/Zip: _____________________________________________________________________ | |
| EMail: ___________________________________________ | Home Phone: ___________________ |
| Website: __________________________________________ | Work Phone: ___________________ |
| Cell Phone: _____________________ | Fax: __________________________ |
Certifications: ____________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
Painting
background: _______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
One Stroke
background: ____________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
Interested in helping with club:
________________________________________________________________________________________________________________
Have you been published, if so, please describe:
__________________________________________________________________________________________________
Interested in painting opportunities:
____________________________________________________________________________________________________________
Interested in painting classes:
____________________________________________________________________________________________________________
Check One:
_____ $15.00 Single One Year Membership
_____ $25.00 Dual One Year Membership
(Must live in the same household - print second form if necessary)
Thank you for your registration!
We can't wait to see you at the next meeting!