Auburn Community Television
Individual Annual Membership

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Name: _____________________________________________________________________

Address: ___________________________________________________________________


City: ______________________ State: ___________ Zip: ___________


Phone:___________________Email:_______________________________________________


Check one
$20 for Charter Cable Subscribers
$30 for Auburn Residents
$40 for Outside Area
(include copy of latest bill)
Signature: ___________________________________________ _________Date: ____________

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Your membership entitles you to special discounts on training classes and tape dubbing, access to the Community Bulletin Board and studio production opportunities and use of video production equipment as well as editing equipment. PLUS you are supporting a very worth while nonprofit cause - public access COMMUNITY television!

Please enclose cash, money order or check made payable to ACTV:
Auburn Community television
P.O. Box 818
Auburn, CA 95604

Thank you for your generous support of this important community resource.