Huntington Camera Club Membership Application
	First Name Last Name City Address Zip Code Email Address Home Phone Cell Phone Username Password Note: Your username is the combination of your first initial and last name and cannot be changed !! Please make checks payable to: Huntington Camera Club P.O. Box 172 East Northport, NY 11731 Type Of Membership: Individual ($75.00) Student ($20.00) Family ($120.00) Senior: 62 & Over ($60.00) Renew Membership New Member If a new member, were you a member of another club or feel your experience warrants competing in class "A" or "M" ? Experience: How many years have you been involved in photography? Please estimate your level of experience : Beginner Intermediate Experienced What medium do you work in? (Check all that apply) : B & W Prints Color Prints Projected Images Programs: I would like to see the club offer programs on the following topics: 1. 2. 3. Is there any photography related program that you could present to the club? Yes No If so, what topic? How did you hear about the Huntington Camera Club ?: Friend Friend's Name : Internet Newspaper Please Specify : Other ( Please Specify ) Lab, Camera Store, Library General Information: Would you like to serve on any committees ( Check all that apply ) ? Club Projects : Competitions : High School Competition : Programs : Often, there are openings for positions on the club's board. Would you lbe interested in serving on the board? Yes No Maybe (Contact Me)