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OCMA  Application For Regular Membership
Annual Dues $85, Initiation Fee $25 Total Dues $110

Please enclose check for this amount.

Mike Stevens
Cox Ohio Publishing
5000 Commerce Center Dr.
Franklin, OH 45005

I,_______________________, hereby make application for admission to membership in the Ohio Circulation Managers Association and promise to abide by the By-Laws adopted under its authority.

I am employed as a circulation executive in connection with the publication of ________________________ a daily newspaper published in the State of Ohio.

In accordance with the objectives of the association, I promise to do all in my power to promote the mutual enlightenment of its members and the furtherance of the best interests of the circulation departments of the newspaper with which they are connected.

Signed___________________________________

Title______________________________________

I, _____(Publisher/Business Manager)____, of the above newspaper hereby affirm that ________________________ is a member of our organization in the position given above.

Signed_______________________________________________

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Company_____________________________________________

Business Address______________________________________

City_______________________State_______Zip_____________

Phone (   )____________________Fax (    )_________________

Home Address_________________________________________

City___________________________State_______Zip_________

Phone ( )_________________Spouse’s Name_______________

Email Address ________________________________________

Date presented to Board of Directors_______________________

Date elected at a regular Association meeting_______________

Date and amount received_______________________________

Know an circulation executive who should join OCMA? Give him or her this form to mail with a $110 check ($85 for annual dues plus $25 initiation fee) to the address below.

Mike Stevens
Cox Ohio Publishing
5000 Commerce Center Dr.
Franklin, OH 45005


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