Date____________________

Name____________________________________________

Street__________________________________________

City_____________________________State__________

Zip___________Telephone___________________________

Email___________________________________________

Type of Membership (Check One)

  Student (21 or under)    $5

  Associate ............... $15

  Artist ..................... $30

  Sponsor ................. $35

Please check the appropriate box(es) for activities with which
you would like to help.

  Fall Exhibit

  Spring Exhibit

  Hospitality

  Officer/Committee

  Other_____________________________________

Preference of Medium

  Oil

  Watercolor

  Pastel

  Acrylic

  Sculpture

  Photography

  Other_________________________________

How did you hear of us? __________________________
______________________________________________
______________________________________________

Dues are due annually in September.
Please print this form and return it with money order or check
payable to Reading Art Association, Inc. at the above
address. We hope you will enjoy this year with us.