ACTIVE & ASSOCIATE MEMBERSHIP APPLICATION

 

Annual Dues:

Active - $30 (one year), $55 (two years) and $80 (three years)

Associate -- $30 (one year)

 

                Name _____________________ _______________________________________________________

 

 

                Home Address, including ZIP Code ___________________________________________________

 

 

                Telephone _______________________    E-Mail Address _________________________________

 

 

                Business Address, including ZIP Code ________________________________________________

 

 

                Telephone _______________________    E-Mail Address ________________________________

 

 

 Please review the Membership Qualifications and Professional Standards section  and select

 one or more of the following membership categories that would make you eligible for membership:

 

                ___ Newspaper  ___ Radio   ___Television   ___ Magazine

 

                ___ Photography   ___Newsletter   ___News Release  ___Movie  

 

                ___ Book    ___Electronic    ___Audiocassette   ___Videocassette

 

                In the past 12 months I have sold material to ­­__________________________________________

 

                _________________________________________________________________________________

 

Member of SEOPA? _______     OWAA? _______   Other organizations? __________________

 

 

Applicant’s Signature _____________________________________________

 

Send your completed application and payment for dues to:

 

                Owen Schroeder

                TOWA Secretary-Treasurer

                188 Sloan Road

                Clarksville, TN 37043

 

 

I attest by my signature that the above information is true and that no information bearing upon my application or classification has been withheld.

 

                                                                                *************

 

Date Received ________________        Approved By ________________         Date Approved ________________