2015 EUROPE MEMBERSHIP FORM

MEMBERSHIP REQUIRED AMOUNT DUE Mr. Ms. (choose type) Name: PromaxBDA ELITE €1,495.00 Title: PromaxBDA €225.00 Organization: Address:

City: Province: Country: Postal Code: Phone: Fax: Email: Website:

PLEASE CHECK THE APPROPRIATE BOXES IN THE 4 AREAS BELOW TO PROVIDE INFORMATION ABOUT YOU AND YOUR COMPANY

1 CHANNELS (NBC, MTV, FOX, Canal+, MSOS/MVPDS (Comcast, Time ACADEMIC 3 JOB LEVEL BBC, A+E, etc) Warner, Star, DIRECTV, Virgin Media, etc.) Educator Executive Management (CMO, Cable Channel (MTV, Discovery, Bravo, Cable (Comcast, Time Warner, Virgin EVP, SVP, Managing Director, etc.) Student Disney Channel, etc.) Media, ONO, etc.) Senior Management (VP, Executive Broadcast/Terrestrial Network (NBC, ZDF, Satellite (DIRECTV, DISH, SKY, etc.) SPORTS TEAMS & LEAGUES Producer, etc.) CBS, BBC, DR, etc.) Game/Entertainment Console (Xbox, Teams Director Pay TV/Subscription Channel (HBO, Playstation, etc) Mid-Level (producer, manager, etc.) Eurosport, LAPTV, Showtime, etc.) Leagues & Governing Bodies Internet (Hulu, iTunes, Youtube, etc.) Entry Level (assistant, coordinator, etc.) Satellite Channel (Audience Network, Mobile (AT&T, Orange, Verizon, etc.) DEPARTMENT/AREA ARTE, DW-TV, etc.) 2 OF BUSINESS 4 JOB DESCRIPTION Internet Channel (Pitchfork, Machinima, SERVICE VENDORS/ Marketing Crackle, etc.) AGENCIES/CONSULTANTS Marketing On-Air Promotion Design/Motion Graphics/Animation Promotion LOCAL/REGIONAL BROADCAST Creative Services TELEVISION (KXLY, NY-1, WPIX, KCET, Creative Services/Advertising Agency Design Comcast Sports Net, etc.) Programming Production – Live Action Sales Local Station (KOMO, KCAL, WNBC, Design Post Production/VFX/Editing Services Programming & Production etc.) Distribution Affiliate Marketing Public Relations Affiliation #1 Internet/Interactive Services (creative, technical, etc.) Network Affiliate Marketing Affiliation #2 Integrated Marketing Research Affiliation #3 Legal Services Technical Interactive/On-Line Ownership/Station Group Media/Strategy Agency Research Media Planning Music & Sound: Licensing, Library, Education/Training Composition PR Call Letters Strategy Research Company Production Regional Channel/Network (NY-1, Fox Finance Sports Networks, CTV Toronto, etc.) PR Agency Post Production Other: Station Groups (Gannett, Tribune, Recruitment Agency Creative Services Sinclair, LIN, etc.) Voiceover Legal CONTENT PRODUCERS, Premiums/Incentives Provider PROGRAM DEVELOPERS, Ad Sales SYNDICATORS, DISTRIBUTION Event Production/Special Events Business Development/Sales (Warner Bros. Television, Endemol, Sony Technology Provider HR/Recruitment Television, Shine, etc) Talent Agency Other/Independent Studio /Program Production (Shine, Independent Consultant/Freelance Endemol, Lionsgate, etc.) Syndicator/Distributor (Warner Bros OTHER RENEW ONLINE! Television, Debmar Mercury, Sony Television, etc.) Trade Association or Conference Visit promaxbda.org and click on the “membership” tab to get started. Home Entertainment (Walt Disney Publications (trade, industry, consumer) Studios, 20th Century Fox, BBC Home Entertainment, etc)

METHOD OF PAYMENT Payment must accompany this invoice; please do not email/mail separately. Membership Renewal Fee € Visa Mastercard American Express Total Amount € Exp Date (MM/YY) Security Code Credit Card # Signature

Please mail completed form along with payment to: Fax (credit card payments only): +1 310.788.7616 NOTE: PromaxBDA memberships are individual memberships and are not transferable or refundable. Memberships can be purchased on a year-round basis, but are based on the PromaxBDA For additional information, please call Member Services at calendar year and will expire 31 December. Any questions or concerns should be directed 1522e Cloverfield Blvd. to Member Services. PromaxBDA membership dues are not deductible as a charitable +1 310.789.1509 or email [email protected]. contribution for Federal or National tax purposes. However, they may be tax deductible as Santa Monica, CA 90404 ordinary and necessary business expenses. Usually 100% of your dues are tax deductible, USA because PromaxBDA does not participate in any lobbying activities on behalf of its members. Always consult your advisor regarding these matters.