Download and print this form, fill it in and send it to the address below.   Please give email address if you have one.

       
           BFI/BFFS AWARD WINNER

Single member 6 concessions 5

Cheques / PO payable to 'Film club at the Roxy'

Please send to:
Film Club at the Roxy, 2 Hillside Road, Ulverston,Cumbria, LA12 9LB

New members may join at 7.30 pm on the night of each film but to help us avoid delays may we urge you to PLEASE join in advance using this application form.

ANNUAL MEMBERSHIP APPLICATION FORM

Please print name and full address

Name(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Address:. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Please give email address if you have one. . . . . . . .. . .. . . . . . . . . . . . . . .. . . . . . . . . . . . . .

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I heard about Film club at the Roxy through . . . . . . . . . . . .. . .. . . .. . . . . . .. . . ..

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I am/we are over 16 years of age                                  Signed . . . . . . . . .. . . . . . . . . . .

And enclose . . . . . . . . . . . . . .

nb. one form per household                                                                                                     

(website form)