MEMBERSHIP APPLICATION (January 2008 – December 2008)

 
 

SPONSOR (MEMBER’S NAME)
NAME
POSITION/TITLE
COMPANY
STREET ADDRESS
CITY/STATE/ZIP
MAILING ADDRESS (if different)
PHONE FAX
E-MAIL
Check $100.00
VISA/MC

$100.00  

CC Number 
Expiration
Signature
Today’s Date
Amount Enclosed

Please make your check payable to FAME in Entertainment and mail it together with this Membership Application to:

FAME in Entertainment

2934 ˝ Beverly Glen Circle

PMB #108

Los Angeles, CA 90077-1724