This is the AMA Collegiate Application for the 2011-12 school-year. Current students at DCTC can download this form, fill out the top portion with their information, sign the second page, and mail the document to the DCTC AMA Club Advisor on the Apple Valley, MN campus. A $20 check made out to DCTC should be sent with the application. DCTC will cover the rest of the cost of the collegiate membership. The advisor will fill out the rest of the application. Check out http://www.dctcamaclub.wordpress.com/ for more information on the DCTC AMA student club.

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