Movie Membership Form Please enable JavaScript in your browser to complete this form.Membership Level *Individual - $50Couple - $75Family (up to four persons) - $125 (each additional family member is $25)Director - $500 (Includes all benefits plus one Super Golden Ticket (good for unlimited movies & medium popcorn each visit)Producer - $750 (Includes all benefits plus one Super Golden Ticket (good for unlimited movies & medium popcorn each visit)MEMBERSHIP BENEFITS- All movies just $6 (includes Historic Preservation Fee) Discounts on popcorn and soft drinks, Monthly membership specials, Complimentary birthday movie ticket, Discounted alternative movie content Member Information: Please include full name, address, phone, email, and birthday *Additional Member Information: Please include full name, address, phone, email, and birthday*if applicableAdditional Member Information: Please include full name, address, phone, email, and birthday*if applicableAdditional Member Information: Please include full name, address, phone, email, and birthday*if applicableChoose your payment *CheckCredit CardPlease make checks payable to Bradford County Regional Arts Council Return form and payment/payment information to: BCRAC | 601 Main Street | Towanda, PA 18848 For inquiries, please call 570-268-2787 or email info@bcrac.org Credit Card TypeVisaMasterCardDiscoverAmerican ExpressAmount to charge$50$75$125$500$750See Membership Descriptions for amountCredit Card Number:Expiration Date:Security Code:Name as it appears on card:Billing Address:PhoneSubmit For a downloadable copy of this form click here.
