MEMBERSHIP APPLICATION
First Name
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Last Name
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Organization
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Job Title
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Address
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Address (2)
City
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State
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Zip
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Work Telephone
Cell Phone
Email Address
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Website
Media Type
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Radio
Television
Author
Internet
Film
Publishing
Agency
Music
Annual Membership Type (Please select one)
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Individual Membership - $99
Associate Membership (non-media women) - $125
President's Club - $500
Organization (3-6 Members) - $300
Organization (7-10 members) - $500
Student Membership - $25
New or Renewing Membership?
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New Membership
Renewal
Statement of Faith
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I have read and agree with the Statement of Faith.
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Women in Christian Media is a division of Joy TV International.