OAB Membership Application - Radio "*" indicates required fields Directory InformationPlease provide the following directory information.License City* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Licensee / Owner* First Last Call Letters* AM Frequency AM Power AM Format FM Frequency FM Power FM Format Network Affiliations Associations (RAB, NAB, etc.) TelephoneWebsite Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Studio Address (if different) Same as mailing address 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 an invoice. Invoice Number* Amount Due* Payment Options* Credit Card Check The following amount will be charged to your credit card. Note: Please make checks payable to Oklahoma Association of Broadcasters and mail to: 6520 N. Western Avenue, Suite #104Oklahoma City, Oklahoma 73116 Billing Name First Last Billing Address* Same as mailing address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name CAPTCHANameThis field is for validation purposes and should be left unchanged.