2018-2019 CTAM Membership Invoice
(Expires June 30, 2019)
Todays Date: _________________
Name of Member: _________________________________________________________
(Name of Municipality or Access Center IF VOTING MEMBERSHIP or Individual’s Name if NON-VOTING)
Address: __________________________________________________________________________________
City: _____________________________________________________ State: __________ Zip:____________
Day Phone: _____________________________ E-Mail: ___________________________________________
Cell/Alt Phone: __________________________ Website: __________________________________________
Contact Name: __________________________________ Title: _____________________________________
Contact Phone: _________________________ Contact E-Mail: ____________________________________
Please Check Appropriate Membership Category:
____ Voting Membership (Town/Station) $50.00
Person designated to cast vote on behalf of your organization
Name: _________________________________________ Title : ___________________________________
E-Mail: __________________________________________________ Phone: _________________________
____ 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
516 Congress Street
Portland, Maine 04101
Email: [email protected]
Phone: 207 775-2900 x210
Thank you for your support !
Rev. 4/20/18
You may download/print this invoice as a PDF file.