Membership Application for the Manayunk Art Center

Please print out the following form and mail with your check to:
Manayunk Art Center, 419 (rear) Green Lane, Philadelphia PA 19128

Date: __________________________

Name: ________________________________________________________________

For Family, Friend & Patron memberships, names of all children under 21 living in household:

_____________________________________________________________________

Street Address: _________________________________________________________

City, State, Zip: __________________________________________________________

Phone (Best number) _____________________ (Alternatve no.)____________________

Email: ________________________________________ Fax: _____________________

Website address: ________________________________________________________

Profession: _____________________________________________________________

Primary area of interest at MAC:

_____________________________________________________________________

Classes you would like to see offered at MAC:

_____________________________________________________________________

Suggestions for improvement at MAC:

_____________________________________________________________________

Are you interested in volunteering at MAC? In what area?

_____________________________________________________________________