OAB Membership Application - Radio Directory InformationPlease provide the following directory information.License City* City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Licensee / Owner* First Last Call Letters*AM FrequencyAM PowerAM FormatFM FrequencyFM PowerFM FormatNetwork AffiliationsAssociations (RAB, NAB, etc.)TelephoneWebsite Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Studio Address (if different) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code General Manager* First Last General Manager's Email Address* General Sales Manager First Last General Sales Manager's Email Address* Local Sales Manager First Last Local Sales Manager's Email Address* Operations Manager First Last Operations Manager's Email Address* Program Director First Last Program Director's Email Address* Promotions Director First Last Promotions Director's Email Address* News Director First Last News Director's Email Address* Sports Director First Last Sports Director's Email Address* Chief Engineer First Last Chief Engineer's Email Address* SignatureName* First Last Title*Email* Payment MethodHave you already been invoiced with your membership dues?*Yes, I have received an invoice and am ready to make a payment.No, I would like to receive and invoice.Invoice Number*Amount Due* Payment Options*Credit CardCheck Note: Please make checks payable to Oklahoma Association of Broadcasters and mail to: 6520 N. Western Avenue, Suite #104Oklahoma City, Oklahoma 73116 The following amount will be charged to your credit card. $0.00 Billing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20202021202220232024202520262027202820292030203120322033203420352036203720382039 Expiration Date Security Code Cardholder Name EmailThis field is for validation purposes and should be left unchanged.
