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* First Name:		* Last Name:
Title:	(Mr./Miss/Ms./Mrs.)
* Company/ Organization:
* Billing Address:
* City:	* State: ALAKASAZARCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY * Zip:
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City:	State: ALAKASAZARCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY Zip:
* Phone:		Fax:
* Company Profile:	(Please select the Industry that best matches your company/organization.) AdvertisingCollege/UniversityConsultingDirect MarketingEvent/Sports MarketingFilm ProductionFinancialFreelanceGovernmentIndoor AdvertisingInteractive DesignLegalMagazineManufacturingMarketingMarketing ResearchNewspaperOtherOutdoor AdvertisingPhotographyPre-PressPrintingPromotionsPublic RelationsPublishingRadioRetailRetiredSports/EntertainmentTelevisionUtilitiesVideo Production
* Email:		Website:
* Membership (Choose One) Membership in the Marketing Association of Southern Minnesota is by individual, not by organization. Dues include membership in the MASMN for 12 months from the date of processing.
One Year Full Membership   $25.00 One Year Student Membership   $20.00 One Year Student Membership with Club Affiliation   $10.00
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Send Us Your Payment If you would like to send us your payment by mail, please select "Print" from your browser menu. Send your check or money order along with a copy of this completed form to: MASMN P.O. Box 4286 Mankato, MN 56002   Bill Your Payment If you prefer to be billed for your membership, click the "Bill Me" button below and we will send an invoice to you at the Billing Address listed above.