MEA Membership Application

MEA Membership Application
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Please complete all information requested by printing this page and mailing it to the MEA Office:
Marketing Education Association, P.O. Box 27473, Tempe, AZ 85285-7473

GENERAL INFORMATION:

Title:

First Name:

MI:

Last Name:

Company or School:

Mailing Address:

Address 1:

Address 2:

City:

State:

Zip:

Country:

Telephone:

Fax:

E-mail:

First Time Member:	# years X $30.00 =
Professional Member:	# years X $56.00 =
Executive Member:	# years X $111.00 =
Student Member:	# years X $15.00 =
Loyalty Member:	# years X $20.00 =
(for retirees, administrators, former marketing educators)
	Retired Not in Marketing Education
	........ Administration
	........ Business
	........ Vocational
	........ ME Related Training
	........ Nonmarketing
	........ Other
Contribution to MEA "Outreach" Program:
	Voluntary Contribution Amount:

	TOTAL DUE:

PAYMENT INFORMATION:

You may call the MEA Office at 1-602-750-6735 and provide your credit card information or you may print this page and send it in with your payment.

Marketing Education Association, P.O. Box 27473, Tempe, AZ 85285-7473

Please bill me Charge to Visa Charge to MasterCard

Card Number: Expiration Date:

Signature_______________________________________________

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Title:
First Name:
MI:
Last Name:
Company or School:
Mailing Address:
Address 1:
Address 2:
City:
State:
Zip:
Country:
Telephone:
Fax:
E-mail: