MRCC CORPORATE MEMBERSHIP APPLICATION

All fields containing an * are required.

Please check below:

YES, I understand that MRCC will charge me a $325 Corporate Membership fee.
Note: Our Corporate Membership fee is tax deductible (IRS ID number 36-3705722).

NAME: * TITLE: *

COMPANY: *

ADDRESS: *

CITY: * STATE: *ZIP CODE: *

PHONE: * FAX:

EMAIL ADDRESS: *

WEB SITE:


Please specify field of business:

Agency TV Network Radio Station Rep Firm
Client Cable Network Magazine Press Member
Software Supplier TV Station Newspaper Association
Research Supplier Spot Cable Outdoor Other


With Corporate Membership in the Media Research Club of Chicago, your company is allowed the following privileges:

1. Corporate Members are allowed three votes in any MRCC election or other function that requires member voting. Please list below the three people who will represent your company:

NAME: TITLE:

NAME: TITLE:

NAME: TITLE:

2. The MRCC publishes a monthly newsletter called the MRCC REVIEW. Please specify below the number of copies you would like to receive and to whom they should be sent:

I would like to receive copies of the MRCC REVIEW. In addition to the voting members, please send copies to:

1. NAME/ADDRESS/CITY/STATE/ZIP:
2. NAME/ADDRESS/CITY/STATE/ZIP:
3. NAME/ADDRESS/CITY/STATE/ZIP:
4. NAME/ADDRESS/CITY/STATE/ZIP:
5. NAME/ADDRESS/CITY/STATE/ZIP:

Please be careful to click on the appropriate button, below.
Clicking on RESET FORM will clear all your responses.

NOTE: After submitting your membership request, you will be billed through US mail.

 
 
 
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