North Central Cinema United Membership Form

North Central Cinema United Membership
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Theater Name Email Number of Screens
Theater Name Email Number of Screens
Theater Name Email Number of Screens
Theater Name Email Number of Screens
Theater Name Email Number of Screens
Theater Name Email Number of Screens
Theater Name Email Number of Screens
Theater Name Email Number of Screens
Theater Name Email Number of Screens
Theater Name Email Number of Screens
Signature
Thank you for your support of North Central Cinema United!
My Products
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Association Dues
2024 dues rate is $20 per screen with a cap of $2,000. If you have more than 100 screens, please select the 100 option.

$20.00 Number of Screens

Associate Members
Bookers, vendors, etc.

$50.00

Total

$0.00
Should be Empty: