ࡱ> [  bjbj  Apa!\pa!\\\0{}}}}}}$,:GGG{G{GGGpi}C .Gg0G7GG GG\> :   2013-2014 CTAM Membership Invoice (Expires June 30, 2014) Todays Date: ___________________ Name of Member: _________________________________________________________________ (Name of Municipality or Access Center IF VOTING MEMBERSHIP or Individuals Name if NON-VOTING) Address: ________________________________________________________________________ City: __________________________________________ State: _________ 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 with the check to: The Community Television Association of Maine P.O. Box 2124 South Portland, Maine 04116 Questions? Call (207) 767-7615 Thank you for your support! 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