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BAFTA East Coast - BAFTA Mem Ren Form

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BAFTA East Coast - BAFTA Mem Ren Form
The British Academy
of Film and Television Arts, East Coast
Membership Renewal Form

I. Renewing member information:
Name:
__________________________________________________________________________________________
Title & Company:_________________________________________________________________________
Address:
_______________________________________________________________________________________
Phone: (____)_____________ Fax: (____)______________ E-mail: ________________________________
II. Renewing as (check one) :
__
Full Member
:
Professionals with at least 3 years experience working in or with the British or Irish film, television or
interactive industries. Full members are eligible to vote in the prestigious British Academy Film Awards.
__
Associate Member:
C
urrently employed in an entry or support level position with a firm connected with the film,
television or interactive industries.
__
Student Member*:
F
ull time students pursuing a degree in film, television or a related fi eld.
__
Friend:
Wishes to support awareness of the British or Irish film and television industries. (No eligibility requirements)
III. Please provide updated eligibility information for your category of membership:

Professional Credits / Work History:
________________________________________________________

________________________________________________________________________________________
New Industry Awards / Achievements: _______________________________________________________
________________________________________________________________________________________
*Students, list university and field of study: __________________________________________________
IV. Dues:
___ Full Member - $175 ___ Associate Member - $60 ___ Student Member - $60** ___ Friend - $225
**Students, if you cannot afford the annual dues, please attach a letter requesting consideration for a waiver.
Method of payment: ____ Check (payable to BAFTA East Coast, Inc.)
____ MasterCard / Visa # ______________________________________ Exp________
_________________________________________________
Signature
Date
V. Please return completed renewal form with dues payment to: BAFTA East Coast, Inc.
31 West 56
th
St, New York, NY 10019
Phone 212-258-2651 or e-mail
baftaeastcoast@earthlink.net
with any questions.
---------------------------------------------------------------------------------------------------------------------------------------------------
BAFTA use only:
Date check received ___________ Date new membership card sent _____________





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