Ford
Photo Club Member Information form
Membership Renewal:
[ ] New Membership: [ ]
Name:
__________________________________________________
Home address:
__________________________________________
City, state, zip:
______________________________________
Home phone: (_______)___________________________________
Email:
_________________________________________________
I consider myself:
[ ]Beginner [ ]Amateur [ ]Advanced
Do you shoot for
hire (semi pro or professional)?
[ ]Yes [ ]No [ ]Maybe
I'm equipped for / with (check all that apply):
[ ] Point &
Shoot [ ] Interchangeable-lens SLR [ ] Medium format
[ ] Large
format [ ]
Digital [ ]
Pinhole
[ ] Studio lighting [ ]
Film [ ] Underwater
[ ] Advanced lenses [ ]
Flashmeter [ ] Darkroom
[ ] Film
scanner [ ] Photoshop (or other SW) [ ] Telephoto flash
[ ] Remote flash [ ] Digital photo printer [ ] ________________
I'm interested in
the following types of photography (check all that apply)
[ ] Aerial [
] Astro [ ] Abstract
[ ] Advertising [ ] Black & white [ ] Landfills
and sewage plants
[ ] Children [ ]
Color [ ] Digital manipulation
[ ] Infra-red [ ]
Landscape [ ]
Macro
[ ] Micro [ ] Nature [ ] Night
[ ] Other [ ] Pinhole [ ] Portrait
[ ] Sport [ ] Studio [ ] Underwater
Notes or special
interests:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Image Capturing Devices
I have received a copy of the Ford Motor
Company directive pertaining to Image Capturing Devices and Ford Proprietary
Information. I have
read and understand this document.
I will comply with all rules laid out in the Image Capturing Device
document.
Applicant's
Signature ____________________________
Send completed form,
with a check for $12.00 payable to Ford Photo Club, to:
Ford Photo Club
C/o William Kern
30710 Fink