Movie Machine Society

MEMBERSHIP APPLICATION


Name:________________________________________________________

Address:______________________________________________________

______________________________________________________________

______________________________________________________________

Phone: (___)_______
FAX: (___)_______
Email:_______________________

Are you a collector?___
Researcher?___
Academic?___
Dealer?___

Areas of Special Interest:______________________________________________________

________________________________________________________________________________

If you are a collector, tell us about your collection:______________________________________________________

________________________________________________________________________________

How did you learn about the Society?______________________________________________________

Society Annual Dues are payable on January 1st each year for all calendar year.
Members joining during the year are entitled to all issues of the quarterly Sixteen Frames publication for that year.
Current annual Dues including Sixteen Frames: USA $25.00; Outside USA $30.00
Print out this form and mail with dues payment to:

Paul Pottash Sec/Treas
1414 Dorset Lane,
Wynnewood, PA 19096

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