BABYLON 5 FAN CLUB MEMBERSHIP APPLICATION Members will receive their membership kits, which include: A subscription to Fan Club newsletters, Universe Today and Headline News, filled with exclusive interviews, photos, news about Babylon 5, and exciting merchandise offers. An 8x10 Cast Photo Fourth Season Cast Mini-Poster (13"x20") B5 Fan Club Button; Full Color Sticker Membership Certificate (Signed by the show's Executive Producers, J. Michael Straczynski and Douglas Netter) Membership ID Card gives your membership number (needed for special pricing on FC merchandise) along with a userID and access code to the Members Only section of TheStation.com, the B5 Fan Club Web-site. YES! I want to join The Official Babylon 5 Fan Club. Please send my membership kit to: Name: ________________________________________________________________ Age: __________ Address: ________________________________________________________________ City: _____________________________ State: ___________ ZIP: ________ Country: _____________ e-mail address: _________________________________________________________ Suggestions: ____________________________________________________________ __________________________________________________________________________ _____ I am already on the mailing list. _____ I got this form from a friend. Enclosed is $17.95 for a U.S. membership (CA residents add 8.25% sales tax); $19.95 for a Canadian membership; and $24.95 for Foreign memberships. Orders must be in U.S. funds. Send check or money order (DO NOT send cash) made payable to: Babylon 5 Fan Club Easy Ways to Join: 1) Mail: Mail this form to: The Official Babylon 5 Fan Club PO Box 856 North Hollywood, CA 91603 2) Email: Email this form to: membership@thestation.com 3) Online: Access an online membership form at: http://www.thestation.com Easy Ways To Pay: 1) By Check or Money Order Send check or money order made payable to: The Official Babylon 5 Fan Club. DO NOT send cash! 2) By Credit Card -- Visa or MasterCard The credit card billing address must be the same as the shipping address. Credit card #: ___________________________________ Expiration Date ____________ Signature (as it appears on the card) _________________________________________ Please allow 6-8 weeks for delivery. Foreign and Canadian orders are shipped surface, please allow additional time for shipping. All returned checks are subject to a $15.00 service charge.