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Membership Appplication

FLORIDA OUTDOOR ADVERTISING ASSOCIATION, INC.
**********
2009 MEMBERSHIP DUES SCHEDULE

Operator :: Number of faces x $1.35 = TOTAL CHARGE per month ::

Dues based on inventory at $1.35 per face, per month. Minimum dues for 20 faces or less in inventory assessed at $25.00 per month. Maximum dues for 1,500 faces or more assessed at $2,025.00 per month.

Any person, firm, corporation or other business entity engaged in the business of outdoor advertising and is licensed to engage in the business of outdoor advertising within the State of Florida pursuant to §479.04, Florida Statutes.

Outdoor Media :: Number of faces x $.65 = TOTAL CHARGE per month ::

Dues based on inventory at $.65 per face, per month. Minimum dues for 40 faces or less in inventory assessed at $25.00 per month. Maximum dues for 1,500 faces or more assessed at $975 per month.

Any person, firm, corporation or other business entity which sells space for advertising on street furniture, transit or alternative outdoor media displays and which is not required to be licensed pursuant to §479.04, Florida Statutes.

Supplier :: $300.00 annually ::

Supplier of goods/services to billboard owners/operators.

Affiliate :: $200.00 annually ::

Anyone who uses or disseminates advertising through outdoor advertising.

Associate :: $100.00 annually ::

Any person, firm, corporation or other business entity not meeting other classifications which is in any way interested in the development, protection and advancement of the outdoor advertising industry within the State of Florida.

I hereby apply for membership in the FOAA, and agree to pay dues as established by the Board of Directors. By applying for membership I agree to recognize and abide by the FOAA bylaws and conform to the Code of Industry Principles as adopted by the Board of Directors.

* Required
* Electronic Signature(full name)
* Date
* First Name
Middle Name
* Last Name
* Company Name
Principal First Name
Principal Middle Name
Principal Last Name
Principal Title
* Mailing Address
* Mailing City
* Mailing State
* Mailing Zip
Street Address (if different from Mailing)
Street City
Street State
Street Zip
* Telephone
* Fax
* Email
* Parent Company Name
* Parent Company Address
* Parent Company City
* Parent Company State
* Parent Company Zip
Product/Services
* Total Faces
* Total Structures
* Total Faces on Interstates/FAP's
Total Structures on Interstates/FAP's
Check Products Offered
Eco Poster Poster Panel 10’6" x 36’ 12’ x 40’ 14’ x 48’	30-sheet Poster Flex Bus Shelter
Other
* Counties Served
* Major Cities
Affiliations	OAAA ACHA Other
PERSONAL INFORMATION* (Optional - strictly confidential and will not* appear in any publication)
Spouse Name
Home Address
Home City
Home State
Home Zip
Home Phone
Mobile Phone