Camera Cinema Club Membership Form
2005-2006 Program



Print out the form below, fill out and mail to:
Camera Cinema Club
P.O.Box 720728
San Jose, CA 95172-0728


Camera Cinema Club Membership Form
2005-2006 Program



Name ______________________________________ E-Mail _________________

Address ____________________________________________________________

City/State ___________________________________________ Zip _________

Phone: Day _______________ Eve _________________ Fax _______________

Location Choice (check one):  _____ Camera 7 at 10:30 AM
                              _____ Camera 12 at 2 PM
All Screenings on Sundays:
In 2005--Oct 16, Nov 13
In 2006--Jan 8, Feb 12, Mar 19, April 9, May 21, June 11, July 9, Aug 13 


New/Renewing Member Rate (for 3 events):

# of Members  ______   X  $39  =  $ ________ TOTAL

NOTE: This is a savings of $3 per event over the at-the-door price!



Check # ___________________  Cash __________________

Credit Card # __________________________________ MC _____ VISA _____ 

Signature ___________________________________ Expires ______________

Referral/Employee: _________________________________________________

The Camera 12 is at 201 S. Second Street in downtown San Jose; the Camera 7 is in the Pruneyard Shopping Center, 1875 S. Bascom Ave., Campbell.

For Membership Benefits information, check out the Cinema Club Membership Benefits page.

For more details, or to charge by phone, call (408) 871-7774. E-mail form to Club director Tim Sika at celluloiddreams@earthlink.net, or mail to Camera Cinema Club, P.O. Box 720728, San Jose, CA 95172-0728.