Membership Form

Title:      Forename:    Surname:

Address:

Town:

   Post Code:

Telephone:

Email:

Are you happy for us to contact you by email? Yes No (we will not pass your details onto anyone else)

 Full Season Membership @ £30 for all shows: 
CONCESSIONS* @ £20 for all shows :   
      Total:

*Passport to Leisure; Full-time students; Pensioners

I am/We are 16 years of age or over
 

Signature(s):……………………………………….………… Date:………………………

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Please print this page and send it with your payment to:
Membership Secretary, Halifax Film Society, 13 Grandsmere Place, Halifax HX3 0DP
Cheques should be made payable to "Halifax Film Society"