Application Form

   ACTIVE MEMBERSHIP:
The undersigned hereby applies for membership in the Inter American Press Association under the category shown below::
Publications
Corporate
News agencies
Online media

Note: Each application must be accompanied by check in US dollars or the corresponding dues.


Name:
Address:
City:
State:
Country:
Zip Code:
Email:
Phone Number:
Fax:
Circulation:
Audited by:
Type of Publication:
Periodicity:
When Founded:
Number of publications:
Web:
Main representative in IAPA:
Please list separately other persons or publications who should receive IAPA mail:


   ASSOCIATE MEMBERSHIP:

Individual
News agencies
Online media
Academician
Industry Services
Retired

Name of the person:
Organization:
Address:
City:
State:
Country:
Principal activity of the organization:
Fax:

   PAYMENT INFORMATION:
Form of payment: Check
Money Order
American Express (*)
Visa (*)
MasterCard (*)
Bank transfer If you choose this option we will contact you shortly to explain the details of this form of payment.

Payment by credit card incurs a 5% surcharge.

Credit card number:
Expiration date:
Authorization for use of the card:
   
ADDITIONAL INFORMATION REQUIRED FOR MEMBERSHIP APPLICATION:
In addition to the above, please forward the following information to complete the membership application:
• Memorandum with the history of the publication or company.
• Name, personal address and brief summary of the professional background of the three principal shareholders/owners.
• Name, personal address and brief summary of the professional background of the officers (President, Vice President(s), Treasurer and Secretary).
• Name, personal address and brief summary of the background of the Publisher.
• Name, personal address and brief summary of thebackground of the Editor.
• Three professional references of the publication/company.
• Copy of a recent publication, or a description of its news profile for online publications.

Please forward this information to our office:
Attention: Ms. Paola Dirube, Membership Coordinator
Sociedad Interamericana de Prensa, Inc.
1801 SW 3rd. Avenue, Ste 800
Miami, FL 33129
USA
(E-mail: pdirube@sipiapa.org)

   IAPA COMMITMENT:
We pledge ourselves to comply with the charter and by-laws of the Association.



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