Data Management Association - National Capital Region

11654 Plaza America Drive, #600, Reston, VA 20190-4700

202-465-4399 • admin@dama-ncr.org • Fed. ID# 54-1444575

MEMBERSHIP APPLICATION

Name:  
Title:  
Company:  
Address:  
   City:
 
State:    
  Zip:    
Phone 1:
 
Phone 2:    
FAX:    
Email:  
 

Membership Type (Check the one that applies)               DUE UPON RECEIPT

  q  BASIC INDIVIDUAL $70.00
  q  TWO-YEAR BASIC INDIVIDUAL $120.00
  q  CORPORATE/AGENCY (up to five people in total) $325.00
  q  LIFETIME  Onetime membership payment $500.00
  q  RETIRED  An active member for five or more years, now retired $45.00
  q  STUDENT  Full-time student (with copy of Student ID) $10.00

 

Member Employment Profile: Please check applicable boxes:    

q Federal     q State      q County     q City       q Other local/regional government    

q Non-Government organization        q Student       q Retired

 

I’m proud to renew my membership in the Data Management Association!

 

q CHECK/MONEY ORDER payable to DAMA-NCR for $ __________

 

q Please charge my   q VISA     q MasterCard     q Discover

Card No:  
Name on Credit Card:  
Expiration Date:  
Cardholder Authentication Verification Code:  
Signature:  

Send to:   DAMA-NCR
                 11654 Plaza America Drive, #600
                 Reston, VA 20190-4700