ORMCA Associate Membership Application

To Contact Us:

Phone: (405) 840-2117
Fax: (405) 840-2474

3535 N.W. 58th
Suite 770
Oklahoma City, OK 73112

Associate Membership Application

The Associate Member Dues are $675 per year.
The membership year runs from July 1st - June 30th.
If you are not joining at the beginning of the membership year,
please use the following guide to determine your dues:

January	$337.50	July	$675.00
February	$337.50	August	$675.00
March	$337.50	September	$675.00
April	$337.50	October	$506.25
May	$337.50	November	$506.25
June	$337.50	December	$506.25

Company Name:
Contact:
Mailing Address:
City:
State:
Zip Code:
Phone #:
Fax #:
Website Address:
E-mail Address:

Please tell us about your company.

Product/Service Description:
How would you like your company listed on our website and in the directory?

Payment

There are many payment options! Please choose one from the list below.
*Please read the security information for processing credit cards by clicking here.

Credit Card

Visa

MasterCard

                                                                   *Credit Card Number:

                                                    Expiration Date:

Check

Company Check

Personal Check

                                                   Check Number:

By submitting, you authorize the ORMCA to charge the credit card listed above for the
Associate Membership Dues indicated on this form.

By submitting this application for membership, you understand that approval is not guaranteed.
By submitting this application, you also agree to abide by the Association's Constitutions and By-laws.
The applications will be reviewed by the members of the board before acceptance.
Your credit card will only be charged if your application for membership is accepted.