CMC Membership Application

This is a printable form only. Please fill out the following fields, print the page, sign it, and mail/fax it to us at:

Community Media Center
711 Bridge St. NW
Grand Rapids, MI 49504
Fax: (616) 459-3970

Membership Information

Student/Low Income: $24 Individual: $36 Resident Family: $48
Individual Non-Resident: $60 Non-Profit Organization: $72 Family Non-Resident: $84

Family Members for Family Membership (Resident & Non-Resident)

Must live at the same address.

Members for NPO Membership

3 People - Additional people are $20 each


Address:




Home Work Cell
Home Work Cell

Payment Information

$

New Renewal


Television Radio Wealthy Theatre Media Literacy/Education

(not sent over the internet)

Signature: X ___________________________________________

 

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