Imperial County Film Commission Membership Form
Date ________________		(To be filled in by ICFC) Member No. ________________
Amount $____________ ٱ Cash ٱ Check _____________		Heading
Memberships		ٱAccounting ٱ Animals ٱ Auto Rental ٱ Camera Operators ٱ Casting ٱ Catering ٱ Cleaners ٱ Community ٱ Construction ٱ Craft Service ٱ Director ٱ Electrician ٱ Entertainment ٱ Equipment Rentals ٱ Film Services ٱ Financial Institution ٱ Fuel ٱ Government	ٱ Grip ٱ Gym ٱ Hardware ٱ Hotel/Motel ٱ Insurance ٱ Location Manager ٱ Location Scout ٱ Lounge/Club ٱ Makeup Artist ٱ Medic ٱ Medical Services ٱ Mobile Facilities ٱ Office Assistant ٱ Office Supplies ٱ Painter ٱ Photographers ٱ Production Assistant ٱ Production Coordinator	ٱ Producer ٱ Property Owner ٱ Props ٱ Pyrotechnician ٱ Rentals ٱ Restaurant ٱ Retail ٱ Sanitation ٱ Sound Tech ٱ Staffing ٱ Stylist ٱ Talent ٱ Transportation ٱ Wardrobe ٱ Wholesale ٱ Writer ٱ Other ______________
ٱ Property Owners ٱ Talent/Information ٱ Basic ٱ Plus ٱ Key ٱ Principle ٱ Producer ٱ Director ٱ Emmy ٱ Oscar	$0 $25 $75 $150 $500 $1,000 $2,500 $5,000 $10,000 $20,000

Business Name Contact

Address City State Zip

Phone 1( ) Phone 2( ) Phone 3( )

Fax ( ) E-mail URL

Services

ٱ Yes, I would like to volunteer for the following ICFC Committees.
ٱ Fund Raising ٱ Locations ٱ Marketing	ٱ Membership ٱ Special Events ٱ Other _____________________________________

All memberships are for one (1) full year from the date of signing. As a requirement of your membership, you must submit economic information as it pertains to film production companies utilizing your services. If you have volunteered for any committee assignments, you will be notified of committee meetings, as well as, receive recognition for committee success. The Imperial County Film Commission is dedicated to promoting/increasing film production within Imperial County, therefore maximizing the economic potential for all its members. Thank you for your support!

Business Representative Date

ICFC Representative Date