Mail Systems Management Association

Member Application for MSMA-Los Angeles
Please Select
New Membership Application      Renewal Application
Individual $100 / Year      Corporate $200Year (Up To Three Persons)
Primary Member
Name:
Title:
Company:
Address:
City:
State:		Zip+4:
Telephone:	Ext.
E-Mail:
Website:
Additional Member (If applicable)
Name:
Title:
Telephone:	Ext.
E-Mail:
Additional Member (If applicable)
Name:
Title:
Telephone:	Ext.
E-Mail:
Primary Business of Your Company
	Printing/Publishing	Direct Mktg./Mail/Catalog/Retail/Fulfillment
	Mfg./Software Mfg./Equip. Dealer	Government
	Lettershop/Presort Bureau/List Mgmt.	Utilities/Telephone
	Educational Institution	Transportation/Distribution
	Business Svc./Mail & Parcel Store Busi.	Health Svc./Hospital/Pharmacy
	Insurance	Assoc./Non-Profit/Religious/Social Svc.
	Banking/Financial/Real Estate/Law	Consultant
	U.S. Postal Service	Other-Please specify below
Billing Contact (If different than Primary Member)
Name:
Title:
Company:
Address:
City:
State:		Zip+4:
Telephone:	Ext.
E-Mail:
Annual Membership Fees
	Individual - one person - $100/year
	Corporate - up to three people - $200/year
Jamey Giraldi, DMDSM - MSMA Treasurer c/o Administaff 1440 Bridge Gate Drive, Suite 100 Diamond Bar, CA 91765-3933 (909) 569-1057
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