Renewing members , just fill in your name unless other information needs
updating.
Name:__________________________________________________
Address: ________________________________________________
_______________________________________________________
Phone--Home: ___________________ Work: ___________________
Email address:____________________________________________
Company: _______________________________________________
Title or Skill: _____________________________________________
Do you want to be listed on the MFVA web site? ______Yes _____No
If you have any suggestions for links to be included in the site, please list
them.
_______________________________________________________
_______________________________________________________
_______________________________________________________
If you would like to contribute your energies to MFVA, please describe
your interests:
_______________________________________________________
_______________________________________________________
_______________________________________________________
The membership dues are:
$45-professional member per year
$25 student member per year
Print this form and mail with your check to:
Maine Film & Video Assn. P.O. Box 5457 Augusta, ME 04332