Emerging Cinema at the Lake Worth Playhouse
Film Society Membership
Individual Film Society Membership $60 Per Year
“Film Buddies” Film Society Membership $100 Per Year
Name: _________________________________________________
Address: _______________________________________________
City: ________________________ State: _____ Zip: _________
Phone: _________________________________________________
E-Mail: _________________________________________________
My check is enclosed Payable to the Lake Worth Playhouse
Please charge my ____ Visa ____ Mastercard
Credit card number ______________________________ Expiration______
Signature ____________________________________
Mail to:
Lake Worth Playhouse - Film Society
713 Lake Avenue
Lake Worth, FL 33460
Or fax to: 561-586-8832