Membership Application Form

SIGN ME UP

YES, I WANT TO GET IN ON A GOOD THING. SIGN ME UP FOR THE CHILDREN'S ENTERTAINMENT ASSOCIATION. I AM ENCLOSING MY CHECK IN THE APPROPRIATE AMOUNT MADE OUT TO CHILDREN'S ENTERTAINMENT ASSOCIATION, INC.

PLEASE FILL OUT THE FORM BELOW AND SEND IT, TOGETHER WITH PAYMENT, TO:

CHILDREN'S ENTERTAINMENT ASSOCIATION

MEMBERSHIP APPLICATION FORM

Name (Last, First)__________________________________ Title__________________

Company_________________________________

Street Address____________________________________

City, State, Country, Zip or Postal Code_____________________________________

Area Code/Phone No ___________________ Area Code/ Fax No________________

E-Mail Address_____________________ Web Site Address_________________________

PAYMENT INFORMATION

____ New Individual membership - $75 (Renewals - $55)

____ New Company membership (includes up to two individuals) - $125 (Renewals - $100)

____ Additional individuals under company membership - $35.00 each (specify names below)

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