CONTACT INFO (please print)

Name: _______________________________________

Address: _______________________________________

_______________________________________

Phone: _________________________ E-mail: __________________________

COURSE SELECTION

Course Title ______________________________________________________

Course Dates ______________________________________________________

[ ] CFWC MEMBERSHIP -- $50 per year (see Advantages of Membership below)

Signature: ______________________________________Date: ____________

HOW DID YOU HEAR ABOUT US? ____________________________________
________________________________________________________________

PAYMENT.....................Check/Money Order Enclosed: Amount_____________

Payment can be made in two parts:
$50 to reserve a space in a particular course and the rest paid in full one week before the class begins.

------ADVANTAGES OF COMMUNITY FILM WORKSHOP MEMBERSHIP-----
CFWC Membership entitles participants to discounted CFWC courses and FREE seminars.
Membership also includes: discounted access to editing equipment and facilities, 50% discount on
studio rental, individual career consultation and listing in CFWC Job Bank. Individual Membership fee
is $50. Courses priced above $400 include a 1-year FREE membership to Community Film Workshop Council with discounts applicable to all future classes and editing time.

Visit our web sites:
http://www.drumTV.com......http://www.newsnoir.com....http://www.harlemshops.com