Colorado Professional Videographers Association

Membership Application

 

Name: ____________________________________    Date________________________________

 

Company: _________________________________   Birthday (Month & Day Only)__________

 

Established Date: ___________________________

                                                                                       

Address: __________________________________    

               __________________________________     Referred by:_______________________

               __________________________________

 

Phone: _________________Fax: _________________ Cell Phone: ______________________

 

E-Mail: ____________________________ Web Address: _____________________________

 

Membership of Other Organizations:_______________________________________________

 

Degrees or Formal Training:______________________________________________________

 

Text Box: Describe your Professional Videography Experience/Specialty

 

 

 

 

 

Text Box: What do you want to get out of CoPVA?

 

 

 

 

 

 

Is there a committee would you like to serve on?_______________________________________

 

I agree to abide by the By-Laws of this Association and will pay the necessary dues and attend meetings.

 

Signature: ________________________________   Date: ________________________

 

 

------------------------------------DO NOT WRITE-BOARD REVIEW ONLY---------------------------------

 

Membership Status: ____________________        Date Approved: ____________________________

 

Send to: Maureen Bacon  - 11545 W. 102nd Ave., Westminster, CO 80021