Atlas Life Building
415 South Boston Lobby
Tulsa, OK   74103

Tulsa Press Club Membership Application

    Please Print

Name

 

Company

 

Title

 

 

Home Address

 

Home Phone

 

Business Address

 

Business Phone

 

Fax Number

 

 

Membership Categories

Annual Dues

News: Print and Broadcast, Non-Residential $50
Friends of Press: Corporate, partnerships, self-employed, non-profit, affiliate, newsmakers $125
Friends of Press: Additional member $110
Retirees $25
Initiation Fee for New Members $15
Total  

Sponsoring Member:_____________________________________

Title: _________________________________________________

Address to which you wish
newsletter, statements mailed: _________________________________________________

Please circle information you do not wish to have published in the Press Club directory.

Payment: (circle one)    Check or Credit Card

Visa

Account Number

Expiration Date

MasterCard

Account Number

Expiration Date