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UCIMC Membership Form
Thank you for your membership. Please complete this form for IMC records then return to the IMC page to complete your payment.
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First Name
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Last Name
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How are you affiliated with the Independent Media Center?
Bike Project
Books to Prisoners
Makerspace
Public I
School for Designing a Society
WRFU
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Address
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Zip
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Phone
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$50 - Standard Membership
$25 - Low Income Membership
$0 - Sweat Equity Membership
$100 - Organizational Membership
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