Membership Application

Membership Levels

For more information about memberships, visit our member benefits page or call 310.432.1200.

  • $95 Individual
  • $60 Student Rate: Requires submission of a current transcript; please click here for the membership application (PDF format) to print out. Complete the application and fax it along with your transcript to 310.432.1203 attention "Membership".
  • $145 Household     Two members, one address
  • $170 Individual Two-Year
  • $1,000 Indie Alliance
  • $1500 Corporate     Three members, one company
  • $2,500 Diversity Circle     One person.
  • $5,000 Spirit Circle
  • $10,000 Industry Circle

Is this a membership renewal? New Renewal

If you have a promotional code, please enter it here

 

Primary Member

First Name:  
Last Name:  
Title:  
Company:  
Address:  
City:  
State:  
ZIP Code:  
Country:  
Home Phone:  
Work Phone:  
Cell Phone:  
Fax:  
Email Address:  
*Birth Year:  
*Gender: Male         Female
*Ethnicity:
*Nationality: (please specify)
*Occupation:
*Annual Income Range:
 
*NOTE: These fields are entirely optional; however, Film Independent uses them to track demographic information about our members to provide better services to the independent film community. We encourage you to help out by selecting the appropriate choices and assure you that all information is kept strictly confidential and will not be shared with anyone outside Film Independent.

Additional Info

Do you work in the film industry?

  • Yes
  • No

Are you a filmmaker?

  • Director
  • Writer
  • Producer

How did you hear about Film Independent?

  • Web search
  • Calendar
  • Screenings
  • Member
  • Direct Mail
  • Newspaper/Magazine
  • Radio
  • Film Festival
  • Other

    • If other please specify:

With your membership, what Film Independent resources do you plan to use the most?

  • Programs/Education
  • Festival
  • Rentals
  • Screenings
  • Other

    • If other please specify:



I would like to volunteer for Film Independent

I would like information on sponsoring events


Donations

I would like to make an additional donation of .

Secondary Member (Household or Corporate Members only)

First Name:  
Last Name:  
Title:  
Company:  
Address:  
City:  
State:  
ZIP Code:  
Country:  
Home Phone:  
Work Phone:  
Cell Phone:  
Fax:  
Email Address:  
*Birth Year:  
*Gender: Male         Female
*Ethnicity:
*Nationality: (please specify)
*Occupation:
*Annual Income Range:
 
*NOTE: These fields are entirely optional; however, Film Independent uses them to track demographic information about our members to provide better services to the independent film community. We encourage you to help out by selecting the appropriate choices and assure you that all information is kept strictly confidential and will not be shared with anyone outside Film Independent.

Additional Info

Do you work in the film industry?

  • Yes
  • No

Are you a filmmaker?

  • Director
  • Writer
  • Producer


Additional Member (Corporate Members only)

First Name:  
Last Name:  
Title:  
Company:  
Address:  
City:  
State:  
ZIP Code:  
Country:  
Home Phone:  
Work Phone:  
Cell Phone:  
Fax:  
Email Address:  
*Birth Year:  
*Gender: Male         Female
*Ethnicity:
*Nationality: (please specify)
*Occupation:
*Annual Income Range:
 
*NOTE: These fields are entirely optional; however, Film Independent uses them to track demographic information about our members to provide better services to the independent film community. We encourage you to help out by selecting the appropriate choices and assure you that all information is kept strictly confidential and will not be shared with anyone outside Film Independent.

Additional Info

Do you work in the film industry?

  • Yes
  • No

Are you a filmmaker?

  • Director
  • Writer
  • Producer

Your credit card statement is your receipt.
Please allow two weeks for your application to be processed.
Film Independent reserves the right to revoke or refuse membership.
Membership is non-refundable.

FILM INDEPENDENT
9911 West Pico Blvd. 11th Floor
Los Angeles, CA 90035
Phone: 310.432.1200
Fax: 310.432.1203
FilmIndependent.org
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