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Application Form
                  for collegiate membership                                                                                          800.AMA.1150 • 312.542.9001 Fax

Fill out this form completely, including acquiring a Faculty Sponsor signature (below) and signing the Statement of Ethics on the second page.
Please print all information. Return your form with the appropriate payment via fax or mail to
the AMA (see fax number above or mailing address below) and your Collegiate Chapter.                   USE FOR MAIL OR FAX APPLICATIONS ONLY



Applicant Information
Send all mail to my:       School Address        Home Address                                                               Check here if you are a prior member of the AMA.
College/University ___________________________________________________________________________________________________________________________________
  Mr.      Ms. Last Name _________________________________________________                   First Name ________________________________________           Middle Initial ______
Home Address (required for membership) __________________________________________________________________________________________________________________
City ______________________________________________                State/Province _______    Zip/Postal Code ______________       Country _________________________________
Home Phone ( _______ )__________________________________________________                     Home E-mail ____________________________________________________________
School Address (if different than above)____________________________________________________________________________________________________________________
City ______________________________________________                State/Province _______    Zip/Postal Code ______________       Country _________________________________
School Phone ( _______ ) _________________________________________________                   School E-mail ____________________________________________________________
Degree Currently Attaining:         Undergraduate           Graduate            Doctorate    Graduation Date: Month _____________________          Year _____________________




Payment Information
A) National AMA Dues*                                                                        B) Collegiate Chapter Dues
        National Membership Dues                                                   $47.00
        (includes online subscription to Marketing News)                                     IMPORTANT:

        Local Professional Chapter Dues                                                      You must belong to the national AMA headquarters to belong
        (optional for Collegiate Membership—see reverse side for listing
        and add appropriate dues here. For more information, visit                           to a Collegiate Chapter. You’ll need to make two payments:
        MarketingPower.com/chapters)
        Chapter Name _______________________________               +$_________               1)    The national AMA headquarters
                                                                                                   Total from Section A—“National AMA Dues” on this application.
        Membership Dues Subtotal                                          = $_________

AMA Publications at Special Member Prices                                                    2)    Your local Collegiate Chapter
   (in addition to Annual Membership Dues)                                                         Please check with your chapter on campus for dues and
        Marketing Management magazine (Quarterly)                                 + $32.00         payment information.
        Marketing Research magazine (Quarterly)                                     $30.00
        Marketing Health Services magazine (Quarterly)                              $30.00
        Journal of Marketing (Bimonthly)                                            $35.00         Name of University or College
        Journal of Marketing Research (Bimonthly)                                   $35.00
        Journal of International Marketing (Quarterly)                              $30.00
        Journal of Public Policy & Marketing (Semiannual)                           $30.00

        Publications Subtotal                                             = $_________

Total Amount Due                                                                              Faculty Sponsorship
   Add Membership Dues and Publications Subtotals                        = $__________
                                                                                                  (This application cannot be processed without a Faculty Sponsor signature.)
   Send payment to: American Marketing Association,
                                                                                                  I hereby certify that this applicant is a full-time or part-time registered
   311 S. Wacker Drive, Suite 5800, Chicago, IL 60606-6629
                                                                                                  student not currently employed in a professional position.
Method of Payment
        Check (payable to the AMA in U.S. funds drawn from a U.S. bank—DO NOT SEND CASH)
                                                                                                  Faculty Sponsor Signature
        American Express         Discover        MasterCard              VISA


   Card Number                                   3-Digit Security Code      Exp. Date                                         * AMA membership is individual and nontransferable.



                                                                                                                                                                                »
   Signature                                     Date
                                                                                                                                                            continued
Application Form
                     for collegiate membership

Join Your Local Professional Chapter
As a Collegiate member, you may also join your local Professional Chapter at a special student rate. Your active participation in an AMA
Professional Chapter will provide the connections, career information, networking and leadership opportunities that you will find nowhere else.
Professional Chapters exist in more than 75 communities throughout North America, and are valuable resources for students looking for important
industry news and programs. Professional Chapters offer a variety of seminars, speaker programs, networking events and other benefits.
To join a Professional Chapter, find the dues below and add that amount to the Payment Information on the first page of this application.
For more information on AMA Professional Chapters, or to find the Professional Chapter in your area, visit our website at
MarketingPower.com/chapters or call 800.AMA.1150.

Local Professional Chapter Listings
ALABAMA                                                                 HAWAII                                                                      MISSOURI                                                                  RHODE ISLAND
Birmingham .......................................No Dues               Hawaii............................................................ $5       Kansas City ........................................No Dues               Southeast New England............................. $10
                                                                                                                                                    St. Louis .............................................No Dues            SOUTH CAROLINA
ALASKA                                                                  ILLINOIS
Alaska (Anchorage) ..................................... $15            Central Illinois                                                            NEBRASKA                                                                  Charleston ................................................... $10
                                                                                                                                                    Greater Omaha ........................................... $10             TENNESSEE
ARIZONA                                                                   (Bloomington/Champaign/Peoria) ......... $2
                                                                                                                                                    Lincoln ........................................................ $10      Knoxville ..................................................... $40
Tucson........................................................... $5    Chicago ....................................................... $25
Phoenix .......................................................... $8                                                                               NEVADA                                                                    Nashville...................................................... $15
                                                                        INDIANA                                                                     Las Vegas .................................................... $10
CALIFORNIA                                                                                                                                                                                                                    TEXAS
                                                                        Indianapolis ................................................... $5         Reno/Tahoe .................................................. $5          Austin............................................................. $5
Inland Empire                                                           Michiana (South Bend/Elkhart) .................. $5                         NEW JERSEY                                                                Dallas/Ft. Worth .......................................... $5
   (Riverside/San Bernardino) ................... $15
                                                                        IOWA                                                                        New Jersey* (Newark)................................ $10                  Houston..............................................No Dues
Orange County ........................................... $10                                                                                                                                                                 San Antonio .......................................No Dues
Sacramento Valley ........................................ $5           Iowa (Des Moines) ....................................... $0                NEW MEXICO
San Diego ...................................................... $5     KANSAS                                                                      New Mexico (Albuquerque) .............No Dues                             UTAH
San Francisco Bay Area .............................. $15                                                                                                                                                                     Utah (Salt Lake City) ................................. $10
                                                                        Kansas City ........................................No Dues                 NEW YORK
Silicon Valley                                                          Wichita ...................................................$12.50           New York* (City)........................................ $15              VIRGINIA
   (Santa Clara/San Jose) ........................... $10                                                                                           NY Capital Region (Albany).............No Dues                            Central Virginia
Southern California                                                     KENTUCKY                                                                    Rochester....................................................... $5          (Charlottesville) ....................................... $2
   (Los Angeles) .......................................... $10         Louisville ....................................................... $5                                                                                 Hampton Roads (Norfolk)......................... $15
                                                                                                                                                    NORTH CAROLINA
                                                                                                                                                                                                                              Richmond ...................................................... $5
COLORADO                                                                LOUISIANA                                                                   Charlotte ....................................................... $5
Colorado (Denver) ....................................... $5            New Orleans ................................................. $3            Triangle (Raleigh) ...................................... $10             WASHINGTON
                                                                                                                                                                                                                              Puget Sound (Seattle) ................................... $5
CONNECTICUT                                                             MARYLAND                                                                    OHIO
Connecticut (Hartford) ................................ $5              Baltimore ....................................................... $5        Akron/Canton ............................................... $5           WISCONSIN
Fairfield County............................................ $5                                                                                     Cincinnati .................................................... $10       Madison ......................................................... $8
                                                                        MASSACHUSETTS                                                               Cleveland..................................................... $10        Milwaukee ..................................................... $5
DISTRICT OF COLUMBIA                                                    Boston.......................................................... $10        Columbus ...................................................... $5        U.S. TERRITORY OF GUAM
Washington, DC ........................................ $10                                                                                         Dayton ........................................................... $5
                                                                        MICHIGAN                                                                                                                                              Guam ........................................................... $20
FLORIDA                                                                 Detroit ........................................................... $5      OKLAHOMA
                                                                                                                                                    Oklahoma City ..................................No Dues                   CANADA
Central Florida (Orlando)............................ $5                Michiana ........................................................ $5
                                                                                                                                                    Tulsa .............................................................. $5   British Columbia (Vancouver)..........No Dues
Jacksonville .................................................... $5
                                                                        West Michigan                                                                                                                                         Province of Québec/Montreal..........No Dues
South Florida                                                                                                                                       OREGON
                                                                          (Grand Rapids) ......................................... $5                                                                                         Toronto ......................................................... $5
   (Ft. Lauderdale/Miami) ........................... $5                                                                                            Oregon (Portland) ...................................... $10
Southwest Florida (Naples/Ft. Myers) .... $20                           Southwest Michigan
                                                                                                                                                    Willamette Valley ....................................... $25
Tampa Bay .................................................... $5         (Kalamazoo/Battle Creek) ...................... $20
                                                                                                                                                    PENNSYLVANIA                                                              * Individuals living in the New Jersey/New York
GEORGIA                                                                 MINNESOTA                                                                   Philadelphia................................................... $5          area have the option of joining the New Jersey
Atlanta ......................................................... $20   Minnesota (Minneapolis) ............................. $5                    Pittsburgh .................................................... $15         chapter, the New York chapter, or both.




Save Money After Graduation with a Young Professional Membership
Upon graduation, you are eligible to renew as a Professional member                                                                                 Professional membership will help you to stay on top of all the
at less than half the price through the AMA ’ s Young Professional                                                                                  important industry news and trends that will keep you competitive in
Membership Program. Young Professional membership offers the                                                                                        your career. Especially at the start of your career, you’ll want to take
full benefits of Professional membership, and is available only to                                                                                  advantage of the opportunities you’ll find through membership with the
recent graduates.                                                                                                                                   world’s largest organization of marketers, the AMA.



Statement of Ethics In order to validate your application, you must sign this Statement of Ethics.
As an AMA member, I agree to abide by the AMA Statement of Ethics                                                                                   Any AMA member found to be in violation of the Statement of Ethics
which guides marketers’ professional conduct.                                                                                                       may have his or her Association membership suspended or revoked.
• The basic rule of professional ethics: not knowingly to do harm.                                                                                  A complete copy of the AMA Statement of Ethics is available online
• The adherence of all applicable laws and regulations.                                                                                             at MarketingPower.com. In order to validate your application,
                                                                                                                                                    please sign the Statement of Ethics.
• The accurate representation of my education, training and experience.
                                                                                                                                                    I subscribe to the Statement of Ethics and will adhere to it:
• The active support, practice and promotion of this Statement of
  Ethics.
                                                                                                                                                    Signature                                                                                                           Date
                                                                                                                                                 0711

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Collegiate Membership Application

  • 1. Application Form for collegiate membership 800.AMA.1150 • 312.542.9001 Fax Fill out this form completely, including acquiring a Faculty Sponsor signature (below) and signing the Statement of Ethics on the second page. Please print all information. Return your form with the appropriate payment via fax or mail to the AMA (see fax number above or mailing address below) and your Collegiate Chapter. USE FOR MAIL OR FAX APPLICATIONS ONLY Applicant Information Send all mail to my: School Address Home Address Check here if you are a prior member of the AMA. College/University ___________________________________________________________________________________________________________________________________ Mr. Ms. Last Name _________________________________________________ First Name ________________________________________ Middle Initial ______ Home Address (required for membership) __________________________________________________________________________________________________________________ City ______________________________________________ State/Province _______ Zip/Postal Code ______________ Country _________________________________ Home Phone ( _______ )__________________________________________________ Home E-mail ____________________________________________________________ School Address (if different than above)____________________________________________________________________________________________________________________ City ______________________________________________ State/Province _______ Zip/Postal Code ______________ Country _________________________________ School Phone ( _______ ) _________________________________________________ School E-mail ____________________________________________________________ Degree Currently Attaining: Undergraduate Graduate Doctorate Graduation Date: Month _____________________ Year _____________________ Payment Information A) National AMA Dues* B) Collegiate Chapter Dues National Membership Dues $47.00 (includes online subscription to Marketing News) IMPORTANT: Local Professional Chapter Dues You must belong to the national AMA headquarters to belong (optional for Collegiate Membership—see reverse side for listing and add appropriate dues here. For more information, visit to a Collegiate Chapter. You’ll need to make two payments: MarketingPower.com/chapters) Chapter Name _______________________________ +$_________ 1) The national AMA headquarters Total from Section A—“National AMA Dues” on this application. Membership Dues Subtotal = $_________ AMA Publications at Special Member Prices 2) Your local Collegiate Chapter (in addition to Annual Membership Dues) Please check with your chapter on campus for dues and Marketing Management magazine (Quarterly) + $32.00 payment information. Marketing Research magazine (Quarterly) $30.00 Marketing Health Services magazine (Quarterly) $30.00 Journal of Marketing (Bimonthly) $35.00 Name of University or College Journal of Marketing Research (Bimonthly) $35.00 Journal of International Marketing (Quarterly) $30.00 Journal of Public Policy & Marketing (Semiannual) $30.00 Publications Subtotal = $_________ Total Amount Due Faculty Sponsorship Add Membership Dues and Publications Subtotals = $__________ (This application cannot be processed without a Faculty Sponsor signature.) Send payment to: American Marketing Association, I hereby certify that this applicant is a full-time or part-time registered 311 S. Wacker Drive, Suite 5800, Chicago, IL 60606-6629 student not currently employed in a professional position. Method of Payment Check (payable to the AMA in U.S. funds drawn from a U.S. bank—DO NOT SEND CASH) Faculty Sponsor Signature American Express Discover MasterCard VISA Card Number 3-Digit Security Code Exp. Date * AMA membership is individual and nontransferable. » Signature Date continued
  • 2. Application Form for collegiate membership Join Your Local Professional Chapter As a Collegiate member, you may also join your local Professional Chapter at a special student rate. Your active participation in an AMA Professional Chapter will provide the connections, career information, networking and leadership opportunities that you will find nowhere else. Professional Chapters exist in more than 75 communities throughout North America, and are valuable resources for students looking for important industry news and programs. Professional Chapters offer a variety of seminars, speaker programs, networking events and other benefits. To join a Professional Chapter, find the dues below and add that amount to the Payment Information on the first page of this application. For more information on AMA Professional Chapters, or to find the Professional Chapter in your area, visit our website at MarketingPower.com/chapters or call 800.AMA.1150. Local Professional Chapter Listings ALABAMA HAWAII MISSOURI RHODE ISLAND Birmingham .......................................No Dues Hawaii............................................................ $5 Kansas City ........................................No Dues Southeast New England............................. $10 St. Louis .............................................No Dues SOUTH CAROLINA ALASKA ILLINOIS Alaska (Anchorage) ..................................... $15 Central Illinois NEBRASKA Charleston ................................................... $10 Greater Omaha ........................................... $10 TENNESSEE ARIZONA (Bloomington/Champaign/Peoria) ......... $2 Lincoln ........................................................ $10 Knoxville ..................................................... $40 Tucson........................................................... $5 Chicago ....................................................... $25 Phoenix .......................................................... $8 NEVADA Nashville...................................................... $15 INDIANA Las Vegas .................................................... $10 CALIFORNIA TEXAS Indianapolis ................................................... $5 Reno/Tahoe .................................................. $5 Austin............................................................. $5 Inland Empire Michiana (South Bend/Elkhart) .................. $5 NEW JERSEY Dallas/Ft. Worth .......................................... $5 (Riverside/San Bernardino) ................... $15 IOWA New Jersey* (Newark)................................ $10 Houston..............................................No Dues Orange County ........................................... $10 San Antonio .......................................No Dues Sacramento Valley ........................................ $5 Iowa (Des Moines) ....................................... $0 NEW MEXICO San Diego ...................................................... $5 KANSAS New Mexico (Albuquerque) .............No Dues UTAH San Francisco Bay Area .............................. $15 Utah (Salt Lake City) ................................. $10 Kansas City ........................................No Dues NEW YORK Silicon Valley Wichita ...................................................$12.50 New York* (City)........................................ $15 VIRGINIA (Santa Clara/San Jose) ........................... $10 NY Capital Region (Albany).............No Dues Central Virginia Southern California KENTUCKY Rochester....................................................... $5 (Charlottesville) ....................................... $2 (Los Angeles) .......................................... $10 Louisville ....................................................... $5 Hampton Roads (Norfolk)......................... $15 NORTH CAROLINA Richmond ...................................................... $5 COLORADO LOUISIANA Charlotte ....................................................... $5 Colorado (Denver) ....................................... $5 New Orleans ................................................. $3 Triangle (Raleigh) ...................................... $10 WASHINGTON Puget Sound (Seattle) ................................... $5 CONNECTICUT MARYLAND OHIO Connecticut (Hartford) ................................ $5 Baltimore ....................................................... $5 Akron/Canton ............................................... $5 WISCONSIN Fairfield County............................................ $5 Cincinnati .................................................... $10 Madison ......................................................... $8 MASSACHUSETTS Cleveland..................................................... $10 Milwaukee ..................................................... $5 DISTRICT OF COLUMBIA Boston.......................................................... $10 Columbus ...................................................... $5 U.S. TERRITORY OF GUAM Washington, DC ........................................ $10 Dayton ........................................................... $5 MICHIGAN Guam ........................................................... $20 FLORIDA Detroit ........................................................... $5 OKLAHOMA Oklahoma City ..................................No Dues CANADA Central Florida (Orlando)............................ $5 Michiana ........................................................ $5 Tulsa .............................................................. $5 British Columbia (Vancouver)..........No Dues Jacksonville .................................................... $5 West Michigan Province of Québec/Montreal..........No Dues South Florida OREGON (Grand Rapids) ......................................... $5 Toronto ......................................................... $5 (Ft. Lauderdale/Miami) ........................... $5 Oregon (Portland) ...................................... $10 Southwest Florida (Naples/Ft. Myers) .... $20 Southwest Michigan Willamette Valley ....................................... $25 Tampa Bay .................................................... $5 (Kalamazoo/Battle Creek) ...................... $20 PENNSYLVANIA * Individuals living in the New Jersey/New York GEORGIA MINNESOTA Philadelphia................................................... $5 area have the option of joining the New Jersey Atlanta ......................................................... $20 Minnesota (Minneapolis) ............................. $5 Pittsburgh .................................................... $15 chapter, the New York chapter, or both. Save Money After Graduation with a Young Professional Membership Upon graduation, you are eligible to renew as a Professional member Professional membership will help you to stay on top of all the at less than half the price through the AMA ’ s Young Professional important industry news and trends that will keep you competitive in Membership Program. Young Professional membership offers the your career. Especially at the start of your career, you’ll want to take full benefits of Professional membership, and is available only to advantage of the opportunities you’ll find through membership with the recent graduates. world’s largest organization of marketers, the AMA. Statement of Ethics In order to validate your application, you must sign this Statement of Ethics. As an AMA member, I agree to abide by the AMA Statement of Ethics Any AMA member found to be in violation of the Statement of Ethics which guides marketers’ professional conduct. may have his or her Association membership suspended or revoked. • The basic rule of professional ethics: not knowingly to do harm. A complete copy of the AMA Statement of Ethics is available online • The adherence of all applicable laws and regulations. at MarketingPower.com. In order to validate your application, please sign the Statement of Ethics. • The accurate representation of my education, training and experience. I subscribe to the Statement of Ethics and will adhere to it: • The active support, practice and promotion of this Statement of Ethics. Signature Date 0711