I want to Join Winky's Fan Club Today!

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Fill out information and level of membership, enclose check

& return to CAN-ACT or,  mail to: 
CAN-ACT
C/O N. Richards,
4624 N. Hacienda Ave,
Boise ID 83703
 
Name_________________________________________Phone #
 
Address__________________________________City_____________State______Zip________
 
Membership Level:
Individual $5.00
Family (up to 4 members) $10.00
Actor $50-$69
Director $70-$109
Producer $110-$299
Angel $300 +
 
Amount Enclosed $_________________
E-Mail Address________________________________________