2003-2004 CTAM Membership
Invoice 

Community Television Association of Maine

P.O. Box 2124    South Portland, Maine  04116

E-mail:  [email protected]                  Website:  www.ctamaine.org

(Membership Expires June 30, 2004)

 Name of Member:
      (Name of Municipality or Access Center IF VOTING MEMBERSHIP, Individual�s Name if NON-VOTING)          

_____________________________________________________________________  

Address: _____________________________________, Maine ______ (Zip)

Day Phone: __________   Fax:__________   Evenings (optional): __________

E-mail address(es):   _________________________________________________

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

How did you learn about CTAM? ______________________________________________________________

Please Make Check Payable To: The Community Television Association of Maine

And mail with this form  to:

     The Community Television Association of Maine

P.O. Box 2124

South Portland, Maine 04116

Thank you for your support !

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