Associate Membership Application

	BARTON HALL STUDIOS	Associate Membership Application	www.bartonhallstudios.co.uk
Where Northamptonshire artists and designers can develop their art

Please provide the following contact information:

First Name

Last Name

Title

Street Address

Address (cont.)

Town

County

Postcode

Telephone

FAX

E-mail

Website:

My artwork is primarily:

Drawing
Painting
Sculpture
Jewellery
Textile
Mixed media
Other

Brief description of my artwork:

My Barton Hall contact is:

If my application is successful I will pay £20.00 by:

Barton Hall Studios are kindly funded and sponsored by THE WICKSTEED TRUST and