AURORA Club Membership Application

Aurora Club Membership Application
(please use your browser to print)

Please check one:

Individual $60

Family $120

Contributor $300

Individual Life Member $1,000

Corporate Patron $1,200 (and up)

Corporate Benefactor $3,600 (and up)

Aurora Circle $6,000 (and up)

All gifts may be tax deductible. Please check with your tax advisor. JLSF ID # 31-1639219

Mr./Mrs./Ms.

Name:

Address:

Phone:

Fax:

E-mail:

Company Name:

Reason for joining:

Date

Enclosed is my check made payable to "JLSF/Aurora Club" for: $
Please charge my:VISA MasterCard account in the amount:
Card Number Expires

Security code# (The security code is on the back of the credit card, 3 or 4 digits, usually shown after your credit card number on the signature panel)

Signature Amount $
JLSF / Aurora Club
6630 Sunset Boulevard, Hollywood, CA 90028
Tel: (323) 463-9929 Fax: (323) 464-8048
E-mail: CreativeEntpr@worldnet.att.net
For more information, please contact our office or visit our
homepage at: http://home.att.net/~creativeentrp/JLSF

BACK TO JLSF HOME

Individual	$60
Family	$120
Contributor	$300
Individual Life Member	$1,000
Corporate Patron	$1,200 (and up)
Corporate Benefactor	$3,600 (and up)
Aurora Circle	$6,000 (and up)

Mr./Mrs./Ms.
Name:
Address:


Phone:
Fax:
E-mail:
Company Name:
Reason for joining:


Date