2014-2015 CTAM Membership Invoice
(Expires June 30, 2015)
Todays Date: _________________
Name of Member:
______________________________________________________________________________
(Name of Municipality or Access Center IF VOTING MEMBERSHIP or Individual’s Name if NON-VOTING)
Address: ____________________________________________________
City: ________________________________________ Zip:____________
Day Phone: ___________________ Fax: _________________________
Evening Phone: (optional): ____________________
E-mail address: _____________________________________________
Please Check Appropriate Membership Category:
____ Voting Membership (Organization) $50.00
Person designated to cast vote on behalf of your organization
__________________________ Their Phone Number: _____________
____ Non-Voting Membership (Individual) $37.50
____ Non-Voting Membership (Vendor) $50.00
____ Non-Voting Membership (Non-Profit Organization $50.00
How did you learn about CTAM? ________________________________________________________
Please Make Check Payable To: The Community Television Association of Maine
Print out this form , fill it out and mail to:
The Community Television Association of Maine
P.O. Box 2124
South Portland, Maine 04116
Thank you for your support !
Rev. 07-04-2013
You may download this invoice as an MS Word or PDF file.