Science Fiction Club Membership Form

Full Name

First NameLast Name

Email Address

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Home Address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Date of Birth

Date

Preferred Membership Type

Other

Which science fiction subgenres interest you?

Who are your favorite science fiction authors or creators?

Have you participated in any other science fiction clubs or events before? If yes, please describe.

Preferred method of club communication

What would you like to see or do as part of the club? (e.g., book discussions, movie nights, writing workshops, guest speakers)

Signature (Please sign to confirm your membership application)