BASILE FAN CLUB MEMBERSHIP
FORM
www.4BASILE.com
- FOR ONLY $5 - you can be part of the Basile Fan
Club.
- Up to 50% off Tickets to ANY
BASILE Show*
- Discounts on food and drinks
at the club/venue*
- Personalized 8X10 photo signed
by Basile
- Discounts on ALL BASILEWARE
(TM) - including T-shirts, Sweatshirts Hats and more.
- Sneak Peeks in to BASILE'S new
shows
- An updated list of Basile Appearances
*Discounts subject to
approval, contact club/venue for details and availability
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- Print this form, fill it out
and send to:
Offical Basile
Fan Club
- PO BOX 15026
Wilmington, North Carolina 28408
- Name __________________________________________________________
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- Address ________________________________________________________
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- City ______________________________
State ______ Zip ________________
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- E-mail ___________________________________________________________
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- Birthday_________________________
DO NOT SEND CASH
Please enclose check or fill out the credit card information
below
- There is a $5 membership fee.
Make Checks Payable to: BZK
On-Stage Services
- Circle One: VISA MASTER CARD
- Name of Card Holder: ___________________________________
- Account Number : _______ -________
-________ -_________
- Expiration Date:________________________
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- Signature: ___________________________________________
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