The Savannah Gay & Lesbian Film Society

New Membership Application


Choose your Membership Level or Renewal Level:

____STARLET MEMBERSHIP	____Single: $ 50	Dual (w/Partner): $ 95.
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____DIVA MEMBERSHIP	____Single: $100	Dual (w/Partner): $190
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____BETTE DAVIS MEMBERSHIP	____Single: $135	Dual (w/Partner): $250

Please print legibly.

NAME(s) __________________________________________________________________________

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PHONE(s) (day) _____________________________ (evening) ________________________________

EMAIL(s) __________________________________________________________________________

Check all that apply. My movie preferences are: (feel free to rank boxes numerically from 1 - 7 or just X)

___ Gay ___ Lesbian ___Drama ___Comedy ___Musical ___Documentary ___Shorts

Comments: _______________________________________________________________________

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____ I would like to become a SGLFS Volunteer.

Please contact me with more information.

Make check payable to SGLFS and note the level of membership desired in the memo section of your check.
Mail this form with your check to:

SGLFS
P.O. Box 10299
Savannah, GA 31412

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To Be Completed By SGLFS:

Membership period effective from: ____________________________ (date) to __________________________ (date).

Amount Paid ___________________