OAB Membership Application ~ Television

OAB Membership Application - Television

"*" indicates required fields

Comments

This field is for validation purposes and should be left unchanged.

Directory Information

Please provide the following directory information.

License City*

City State

Licensee / Owner*

First Last

Call Letters*

Channel

Network Affiliation (if any)

Associations (NAB, TVB, etc.)

Phone*

Website

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Studio Address (if different)

Same as Mailing Address

Street Address Address Line 2 City State ZIP Code

General Manager*

First Last

General Manager's Email Address*

News Director

First Last

News Director's Email Address

Station Manager

First Last

Station 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

Sports Director

First Last

Sports Director's Email Address

Chief Engineer*

First Last

Chief Engineer's Email Address*

Signature

Name*

First Last

Title*

Email*

Payment Method

Have 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

Note:

Please make checks payable to
Oklahoma Association of Broadcasters
and mail to:

6520 N. Western Avenue, Suite #104
Oklahoma City, Oklahoma 73116

The following amount will be charged to your credit card.

Billing Name

First Last

Billing Address*

Same as Mailing Address

Street Address Address Line 2 City State ZIP Code

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

CAPTCHA

OAB Membership Application ~ Television