ITMA Membership Application

Thank you for your interest in ITMA!

To apply for membership, please complete and submit the application form below.

I.T.M.A. memberships are valid per calendar year and must be renewed each year to be valid for that calendar year. Membership fees are not pro-rated. Please remember your payment goes towards ITMA Scholarships and Educational efforts.

MEMBERSHIP IS CONTINGENT OF RECEIPT OF MEMBERSHIP DUES. ONLY MEMBERS IN GOOD STANDING WILL RECEIVE ALL MEMBER BENEFITS.

Fields captioned in RED require data input in order to submit this form.

Please do not use ALL CAPS

Company Information

Company Name
Company Address
City
State
Zip
Website
Description of Services (40 words max.)
Membership Type
Corporate ($250/yr. for up to five members)
Individual ($50/yr. for one member)
Educator (complimentary membership for one member)
Student (complimentary membership for one member)
Referred by
Individual Member or Primary Corporate Member
Member 1:    First Name:
Last Name:
Title:
Phone (work):
Phone (cell):
Pager:
Fax:
Email:
I wish to become involved in the following ITMA functions:

    Fund Raising Membership Drive
    ITMA Golf Tournaments
    Publicity/Public Relations
    Special Events
    Luncheon Planning
    None at this time

Please Read Carefully

PAYMENT OF MEMBERSHIP DUES MUST BE MADE WITHIN 10 DAYS OF THIS REGISTRATION. ONLINE PAY IS AVAILABLE.

If you are an individual member or if you are the only corporate member representing your company and you have completed all of the information requested above, go to the bottom of this page now and clickthe "Submit" button (only once, please).

Once you have completed all of the information that applies to your membership above, click the "Submit" button - only once, please.

Then follow the stated instructions for paying membership dues.

Dues may be paid by MasterCard or VISA, or by check.

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ITMA 2010 Sponsors

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