AHCT MEMBERSHIP & DUES

The membership year runs from April through March.  Please check the mailing label on your most recent newsletter.  The date by your name shows the end of the period for which membership has been paid (e.g., 3/06 = dues paid through March 2006, time to renew).

To help us keep membership records accurate, make corrections or changes in your address and affiliation, print out the form below and send it along with your check. To simplify payment, please feel free to pay for more than one year ahead.

MEMBERSHIP FORM
Please print out the form below, then complete it and mail it with your check (made payable to AHCT) or credit card information to:

Prof. Anita Stoll
First Vice President AHCT
2081 Lamberton Road
Cleveland Heights, Ohio 44118

a.stoll@csuohio.edu

Please indicate in the bottom left-hand corner of your check that  payment is for dues.          All members of AHCT receive a copy of Comedia Performance.

This form cannot be submitted electronically. Please print from your browser and submit via regular mail.
Name: ___________________________________________________________________________________
Affiliation:_______________________________________________________________________________
Address:_________________________________________________________________________________
Phone:   ________________________________         e-mail: ____________________________________

Membership level                                       

(circle appropriate amount)

$30 Individual
$20 Retired / Student
$35 Patron
$60 Sponsor
$60 Institution
$510 Sustaining (one time only)

Dues for    ________2006-7

                   ________Other (please explain)

Please indicate method of payment:

Check___________   Visa__________     MasterCard_____________

Name (as it appears on your credit card):

_____________________________________________________________

Address (to which your credit card statements are sent):

_____________________________________________________________

Credit card number

_____________________________________________________________

CVV number (last 3 digits on back of card): ________________

Expiration date:  mm/yy          Signature:             

______________                     _____________________________  

MEMBERSHIP & DUES CATEGORIES

  1. Individual Membership  $30 annually  [$5 to be applied to the Everett W. Hesse Memorial Endowment]

  2. Individual Membership (Retired Members / Students)  $20 annually
  3. Patron Membership $35 annually with the privilege of requesting the loan of one video from our archives without charge
  4. Sponsor Membership $60 annually with the privilege of requesting the loan of two videos from our archives without charge and the invitation to attend and participate in the annual meeting of the Board
  5. Institutional Membership $60 annually with the privileges of #4 above
  6. Sustaining Membership $510, payable one time only, with the privileges of requesting the loan of two videos from our archives annually without charge and the invitation to attend and participate in the annual meeting of the board
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