Ditto 11 Membership Form

To purchase a Ditto 11 membership, complete this form and mail it to: Ditto 11, PO Box 1010, Framingham, MA 01701-1010.

Credit card purchases may be faxed to 617-776-3243.

Attending memberships are $30 (US Funds), supporting memberships are $10.

Make checks payable to MCFI. We also accept Visa and MasterCard. Please don't mail cash.

Name(s): _______________________________________________________________

Address: _______________________________________________________________

________________________________________________________________________

City: _____________________________ State/Province: ____________________

Zip/Postal Code: __________________ Country: ___________________________

Phone number: __________________________________________________________

Email Address: _________________________________________________________

I am buying __________ attending membership(s)  at $30 each, total $__________.
I am buying __________ supporting membership(s) at $10 each, total $__________.
I am paying by _____ Check _____ MasterCard _____ Visa

Credit Card # ________________________________________ Exp: ____________

Name on Card: __________________________________________________________

Signature: _____________________________________________________________

Mail your memberships to: Ditto 11 PO Box 1010, Framingham, MA 01701-1010.


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