Pascack Art Association
Membership Application

Monthly Meeting Location
Municipal Office Building/Police Station
350 Hudson Avenue Washington Township, NJ 07675

To apply, please fill out this form and mail with check payable to
Pascack Art Association to the following individual

Herrat Sommerhoff, Membership Chair
898 Westwood Ave
River Vale, NJ 07675
(201-666-9108)

___ $30 single member ___ ($40) Two Family Members (same address)

(Please print clearly)

Name:______________________________________________________

Address: ____________________________________________________

City:_________________ State:___________________ Zip:__________

Telephone: ________________ Fax: _______________

Email: _______________________________________

For additional information call Anneliese Landerer, President, 201-391-5344