BVAL Membership Form

BVAL Membership Form (2010-2011)

Please print and fill out the form below, and then mail your check of $35.00 for annual dues with the form to:

Brazos Valley Art league
C/O Membership Chairperson
2275 Dartmouth, College Station, TX 77840

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Check one: New Member [ ] Renewing Membership [ ]

Enclosed please find $__________Cash or Check (Payable to BVAL)

Date__________________________ Check #__________________________

Name ____________________________________________________________

Address _________________________________________________________________

City ________________________ State _____ Zip ______________________

Phone: Home ______________________ Cell ____________________________

Website (Please print clearly!)

____________________________________________________________________________

Email (please print clearly)______________________________________________________

You will receive an electronic newsletter each month except July and August when there are no

meetings

Art Medium_______________________________

Signature ___________________________________________________________