Epsom and Ewell Art Group

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Application for Membership of Epsom and Ewell Art Group


 

 

Name .....................................................................................      (Mr, Mrs, Miss, Ms)

 

 

Address .......................................................................................................................................

 


....................................................................................................................................................

 


Post Code ...........................



Tel No.(day) ..................................................  (evening) ...............................................................

 

 

Mobile No ......................................................



e-mail .............................................................................

 

 

Age.........................* optional

 


 

Signed ...................................................................   Date ........................................................

 

 


How did you hear about the group?........................................................................................



Your e-mail will be shared only with other members of the club.  It assists in member-to-member communication. 

If you do not want this to happen please indicate with a cross ..............



Your membership details will be stored electronically, the information held will not be shared with any external third party.

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Cheques made payable to- Epsom & Ewell Art Group and given or sent to our Membership Secretary; Roland Vassallo, 32, Harefield Ave, Cheam SM2 7NE

0208 642 2584  e-mail: rmavassallo@gmail.com