Eastern Shore Art League
PO Box 15, Locustville, VA 23404

Membership Dues are due January 1. Names will be deleted from the membership list after March 1
if dues have not been paid.

PLEASE PRINT INFORMATION

Name_________________________________________________________________

Street or PO Box________________________________________________________

City, State, Zip _________________________________________________________

Telephone __________________, Email_____________________________________

Enclosed: $25 single ______ $25 patron ______ $40 family_____

Members Survey: Please complete the entire form below. Make your check out to Eastern Shore Art League. Mail your check and form to: Eastern Shore Art League, PO Box 15, Locustville, VA 23404 Thank you