Member, Federation of NSW and Associated Film Societies . . . . Member, Federation of Victorian Film Societies
PO Box 3107 Bundeena 2230 . . . . Email filmsociety

Application for Membership

Full Year (Jan-Dec) 20__ 9 / 6 / 3 months (terminates December) 20__

$35 $30 / $20 / $15

) Select one )  and enter year

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I, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(full name of applicant - underline Surname

Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Postcode . . . . . . . . . . . .

Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Email (preferred contact method - saves stamps) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
hereby apply to (become a member / renew my membership) of the Bundeena-Maianbar Film Society and agree to be bound by its rules for the time being in force.

Signature of applicant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date . . . . . . . . . . . . . . . . . .

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I, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(full name of proposer - underline Surname)
being a member of the Film Society, nominate the applicant, who is known personally to me, for membership of the Film Society

Signature of proposer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date . . . . . . . . . . . . . .

I, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(full name of seconder - underline Surname)

being a member of the Film Society, second the nomination of the applicant, who is known personally to me, for membership of the Film Society,

Signature of seconder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date . . . . . . . . . . . . . .

-------------------------------------------- Office Use --------------------------------------------

Executive Committee member to initial and date: