Please type in your information, print out this page, and mail it with your payment to:

Key Sunday Cinema Club
P.O. Box 29156
Los Angeles, CA 90029

OR, you may fax it to 1-323-460-6926 (only if paying by credit card).
If you wish for membership cards to be mailed to separate addresses, please fill out a separate form per address.

KSCC ATLANTA - FALL 2008
Full Name:
Returning Member? How many people are joining?
Additional Names:
Address Line 1:
Address Line 2:
City: State: Zip Code:
Phone: Email:
Additional Notes:
IF PAYING BY CHECK: Total Enclosed: Check #
Membership:
IF PAYING BY CREDIT CARD: Total to be charged:
Membership:
Billing Zip Code (if different): Card type: VISA MASTERCARD
Card # Expiration Date (MM/YY):

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