Membership Application

Application for new or renewal membership.
You may also use this form to send us a change of address to update our database.
Please submit the following information, then have your check or Money Order in US Funds payable to AMMA, sent to the following address:

Pat Otto, Treasurer AMMA
9839 Grackle Loop
Lakeland, FL 33810-2314
Phone: 863-858-2106

You may also download a membership form in PDF format, print it, fill it, and mail it with your check.

New Renewal Update

 

TYPE OF MEMBERSHIP

RATE/Yr. (US FUNDS)

 

1) Individual Member

$25

$

2) Second Member, Same Household

$10

$

3) Member Club

$25

$

TOTAL

$

1) Individual Member:

Last Name, First Name, Middle Initial, Mr., Mrs., Ms., Miss

2) Second Member:

Last Name, First Name, Middle Initial, Mr., Mrs., Ms., Miss

3) Member Club:

Club Name, Contact, Position

Address:

City:

State or Province:

Country:

Zip/Postal:

E-Mail Address:

Home Phone:

Work Phone:

Movie Club Affiliation:

(if any) Club Name, Club Contact, Phone

Occupation:

If retired, please indicate the occupation you retired from

Formats Used:

Film:

16mm   Super-8   Regular 8mm
Other:

Video:

VHS   VHS-C   S-VHS   S-VHS-C
8mm   Hi-8   Other:

Camcorder?

Editing?

Do you do Computer Editing?   Yes   No

System Used?