SCHENECTADY
                     PHOTOGRAPHIC
                     SOCIETY 

Membership Application

Please print out this form

( ) New Member
( ) Renewal

Name(s): ________________________________________________________________________

Address: ________________________________________________________________________

	_________________________________________________________________________

	_________________________________________________________________________

Zip: 	__________________

Phone (home): __________________	(work): __________________

E-mail: ________________________________________
NOTE: All family members planning to enter competitions must be listed on application. Print first names for member name tags if different from above:

____________________________________    ____________________________________

Membership dues support program expenses and are $40.00 per year for individual members and for families living together.

Membership desired:
( ) Individual Membership
( ) Family Membership. Print spouse’s name or other participating family member(s) above.

Method of payment:
( ) Check
( ) Cash: bring this filled-out form to the next meeting

If applying by mail, send check payable to the Schenectady Photographic Society and this completed form to:
Linda Heim
Treasurer
39 Greenock Rd.
Delmar, NY 12054