Data Management Association - National Capital Region
11654 Plaza America Drive, #600, Reston, VA 20190-4700
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!

qCheck/Money Order payable to DAMA-NCR for $ __________

q Please charge my  qVISA    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