Television Membership Application

RENEWING
If renewing membership with no changes to station information (i.e. staff, logo, frequency, etc.), use the “Pay Membership Dues” button below to pay with a credit card or bank account.
NEW MEMBER
If applying as a new member or updating station information, please fill out the form below and click the “Submit” button. A separate form for each station should be submitted. An opportunity to make payment will be presented after submitting the form.

Member Dues Scale

Station Information

(if different from above)
(if different from above)

Staff

(first, last)
(if different from above)
(first, last)
(first, last)
(first, last)
(first, last)

Upon clicking the “Submit” button, the opportunity to process payment with a credit card or bank account will be provided. If submitting multiple stations, process the member dues payment once, for all stations, when done submitting.

REFUNDS: If a payment is processed in error, the payment will be refunded minus any transaction or processing fees.

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