Membership Application Form

Name: (Please Print)....................................................................................
Address:.........................................................................................................
.........................................................................................................................
.................................................................Post Code:....................................
E-mail: ............................................................................................................
Telephone: .....................................................................................................

(The above information will be stored on a computer used solely for Film Society purposes)

Membership rates for the 2010/11 season:

Full Membership: £38.00
Senior Citizens, Students and Unwaged: £34.00

(Members are entitled to concessionary prices for all other Merlin Theatre Shows on production of a valid Membership Card)

Please Note: Single evening members are very welcome - Admission at the Box Office
SEATS ARE NOT BOOKABLE IN ADVANCE FOR SOCIETY FILMS

MEMBERSHIP FEE ENCLOSED £..............(Cheques made payable to Haverfordwest Film Society, please)

Return to: Joy Green, Treasurer,
Haverfordwest Film Society, Mitchells Barn, Wiston, Haverfordwest SA62 4PN