Dallas Producers Association - Online Application

Membership is open to any company or individual of high standing, based in North Texas, that has managerial, budgetary or creative control for the production of moving visual media.

Producer category of membership is open to companies or individuals who are actively engaged in the production business as a producer. Definition of a Producer
Associate category of membership is open to individuals and companies who offer support services to the video/film/digital media production industry.

A membership term is for one calendar year beginning at the date of your acceptance by the Board of Directors. Annual dues are $150 and each member-company may select two representatives to receive all the rights of membership. Members have an option to pay an additional fifty dollars ($50.00) to include up to five additional contacts per member-company.

Membership dues can be paid immediately by credit card online or by mailing a check after this application is completed. If paying by check, please mail to Dallas Producers Association, P.O. Box 560183, Dallas, Texas 75356-0183.

COMPANY INFORMATION
*Company Name:
*Membership Type:
*Membership Category:	(hold down the "Ctrl" or "Option" key to select multiple categories)
*Company Description/History:
*Company Credits:
*Years In Business:

*Address 1:
Address 2:
*City:
*State:
*Zip Code:
*Company Phone:
Company Fax:
Company Email:
Website:


PRIMARY CONTACT
*First Name:
*Last Name:
Title:
*Email Address:
Direct Phone:
Extension:


SECONDARY CONTACT
First Name:
Last Name:
Title:
Email Address:
Direct Phone:
Extension:


ADDITIONAL CONTACTS For an additional $50, you may add up to 5 additional contacts
Contact 3 Full Name:
Contact 4 Full Name:
Contact 5 Full Name:
Contact 6 Full Name:
Contact 7 Full Name:


ADDITIONAL QUESTIONS
Do you agree to abide by the DPA Code of Ethics?
	Yes	No
Would you like to volunteer on a DPA Committee?
	Yes	No


PAYMENT INFORMATION
	Credit Card (PayPal)	Company Check
	Total number of representatives (including primary, secondary & additional contacts).