The Ad Club of Western Massachusetts




	DIRECTORY BENEFITS TO APPLY

To become a member, complete the form below and send us a check payable to the Advertising Club of Western Massachusetts. Do you know someone else who should belong? Send us their name and number.

In the form below, fields with an asterisk (*) next to them are required.


*Membership Type new membership renewal
Type the information below as you wish it to appear in the member directory.
*Company:
*Type of Company:
*Street Address:
*City:
*State:
*Zip:
*Phone:
Fax:
Website:

*1. Name:
*Title:
*Email:

2. Name:
Title:
Email:

3. Name:
Title:
Email:

4. Name:
Title:
Email:

5. Name:
Title:
Email:

Membership Category Student - $40 Individual - $125 Corporate (up to 5 members) - $500
Make checks payable to: Advertising Club of Western Massachusetts Post Office Box 2823 Springfield, MA 01101
Additional Info:

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