Become An AAWIC MemberClick here for Membership Information. Membership ApplicationDate: ____________________________________________________Name: ___________________________________________________ Title: ____________________________________________________ Company: ________________________________________________ Primary Business: _________________________________________ Business Address: _________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Phone: ___________________________________________________ Fax:______________________________________________________ E-mail:___________________________________________________ Educational Background College: __________________________________________________ Major: ___________________________________________________ Degree: __________________________________________________ Certificate: _______________________________________________ Professional Background Total number of years in the industry: _________________________ Professional Honors and Awards: _________________________________________________________ _________________________________________________________ _________________________________________________________ Other Professional Memberships: _________________________________________________________ _________________________________________________________ _________________________________________________________ Special Talents and Skills _________________________________________________________ _________________________________________________________ _________________________________________________________ Membership Categories: ___ Corporate Membership $2,500.00 ___ Benefactor Membership $1,000.00 ___ AAWIC Film Friends $100.00 ___ Individual $50.00 ___ Student (Full-Time) $25.00 (You must have valid I.D.) Method of Payment ___ Check ___ Money Order Please make payable to African American Women In Cinema Print the application, completed it, and mail it with your payment to the following mailing address: African American Women In Cinema Credit Card: ____ Master ____ Visa Card Number ______________________________________________ Expiration Date ____________________________________________ Billing name: ______________________________________________ Billing address: ____________________________________________ __________________________________________________________ __________________________________________________________ You can fax completed form to 212-871-2074. * Once your application has been received and processed, you will receive confirmation with additional detail membership information Thank you for joining us! If you have any questions, please e-mail: |