SSCC Membership Form - Credit Card

Name*

First NameLast Name

Email*

example@example.com

Membership Type*

New MembershipRenewal

Home Phone Number (optional)

Please enter a valid phone number.Format: (000) 000-0000.

Mobile Phone Number (optional)

Please enter a valid phone number.Format: (000) 000-0000.

Address (optional - used for club meeting location decisions)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Do you need to update your email, phone, or address information?*

YesNo

Updated Email or blank if it stays the same.

example@example.com

Updated Home Phone Number or blank if it remains the same

Please enter a valid phone number.Format: (000) 000-0000.

Updated Mobile Phone Number or blank if it remains the same

Please enter a valid phone number.Format: (000) 000-0000.

Updated Address or blanks if it remains the same (used for club meeting location decisions)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Membership Class*

IndividualFamily (includes spouse or partner)

How many OTHER family members (or partner) are you including?

123

Name of 1st Additional Family Member (or Partner)*

First NameLast Name

Email of 1st Additional Family Member (or Partner)

example@example.com

Name of 2nd Additional Family Member*

First NameLast Name

Email of 2nd Additional Family Member

example@example.com

Name of 3rd Additional Family Member*

First NameLast Name

Email of 3rd Additional Family Member

example@example.com

Which other camera club(s) do you belong to? (optional)

Do you belong to the Photographic Society of America (PSA)?

YesNo

Would you consider serving on any committees? (check any)

Are there any field trips you'd like to see offered? (optional)

Would you consider leading a field trip?

YesNoMaybe

Would you be interested in presenting a talk on a photography-related subject? Describe your ideas here:

Would you like to see any particular training, coaching, and/or programs offered? Describe your ideas here:

My Products

Individual Membership - Full Year

Full year's dues when you join/renew. Covers the club year ending on June 30th.

$50.00

Family Membership - Full Year

Full year's family dues for all participating family members or partner. Covers the club year ending on the next June 30th.

$80.00

New Individual Membership - Partial Year

Partial year's dues when a NEW member joins between February 1 and June 29. Covers the club year ending on June 30th.

$35.00

New Family Membership - Partial Year

Partial year's family dues for all participating family members or partner when a NEW member joins between February 1 and June 29. Covers the club year ending on June 30th.

$55.00

Contribute to the Community Service Fund

The purpose of the George DeBuchananne Community Service Project Fund is to financially support a photography project that advances a community-related cause. A project may be proposed by a Club member, by another photographer sponsored by a Club member, or by a community organization sponsored by a Club member.

$1.00 Enter whole number of dollars. Will be added to the total. $

Contribution to SSCC

You may contribute to SSCC's operating budget here. Thanks!!!

$1.00 Enter whole number of dollars. Will be added to the total. $

Total

$0.00

Credit Card