Membership Application

This section is intended to be printed and faxed or mailed in. To register via this secure website, please scroll down to next application form.

To send this form, hit Print on your browser, then Fax or Mail to the location listed on the bottom of the form.

YES! I'm looking for the nuts & bolts of Direct Marketing. Sign me up today!

Name:_______________________________________________

Title:________________________________________________

Company:____________________________________________

Address:_____________________________________________

City, State, Zip +4:_____________________________________

Phone:_______________________________________________

Fax:__________________________________________________

E-mail:________________________________________________

Website:_______________________________________________

How did you learn about RMDMA?________________________________________

Check one:

__ Individual Membership $150

__ Corporate Membership $650

(Covers up to 8 people from your company. Please include a list with this form)

__ Check Enclosed (make check payable to RMDMA)

__ Credit Card: __ VISA __ MasterCard__ AMEX

Account Number:_____________________________________

Expiration Date:_______________________________________

Signature:____________________________________________

Total Amount Enclosed:$___________________________________________

Fax it in: 720-922-9414

Mail completed form to:
P.O. Box 620822, Littleton, CO 80162
Questions? Call us at 303-914-8407