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The Membrane Domain

MEMBERSHIP APPLICATION FOR JOINING THE SLUGFEST

MEMBERSHIP APPLICATION

to JOIN in the SLUGFEST

A membership is good for 366 days ( including the day you apply.) The base price is $1,000.00 (which includes shipping, handling, and PA sales tax if shipped within PA)

Please enter the following information:

your first .............................. and last names

e-mail address

street ( or shipping ) address

city, ......................................state, ................................... and zip code

What type of music do you like to listen to?

Please choose your listening format:

  • Cassette Tape
  • Mini-Disc ( Sony compatible. Adds $20.00 to your membership price. )
    Your Internet Gazette password and library card will be emailed to you upon completion of this order.

    An activity questionnaire for the THINK-TANK and THE PHILADELPHIA SPIRIT EXPERIMENT will follow.

    Please choose your payment method:

    Expiration Month: Expiration Year:

    Credit Card Number:

    Snailmail. Payment instructions will follow.

    Thank you.
    Please press this button
    to join the slugest :