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Membership Application Form Group Membership Preferences Fill out this form completely and return it to [email protected] or to the information on the next page. Default preferences will be applied to memberships if form is not received within 7 business days. Completing this form electronically is strongly preferred. Role Marketer Researcher Academic Name Prefix First Middle Last Gender Male Female Primary Address Employer/Institution Title Address Ty p e Home Business School Street Apt/Suite City State ZIP Phone/E-Mail Ph o n e Ty p e Home Area Code Mobile Office Number Extension Email Check if you would like to receive limited text messages from the AMA about your membership. My Organizational Key Contact is Industry (SELECT ONE) Advertising Insurance Technology Automotive Manufacturing Telecommunications Marketing Research Transportation and Warehousing Education Non Profit Travel and Tourism Financial Services Pharmaceuticals Utilities and Energy Food and Beverage Other Government/Public Admin Publishing/Broadcast/Internet Health Care Services Real Estate/Rental and Leasing B to C Arts and Entertainment Consumer Products/Packaged Goods Hospitality/Event Management/Meeting Planning Professional Services Retailing Primary Focus (SELECT ONE) 1-2017 B to B Both Page 1 Membership Application Form Group Membership Preferences Company Size (SELECT ONE) 1 to 9 250 to 999 10000 to 24999 10 to 49 1000 to 4999 25000 employees plus 50 to 249 5000 to 9999 Years of Marketing Experience (SELECT ONE) Less than 5 5 to 9 10 to 19 20+ Highest Degree Attained (SELECT ONE) High School Bachelors Masters Doctorate Decline to answer Interest/Responsibilities (SELECT UP TO 4) Academia Advertising Analytics/Metrics Branding Career Development Consumer Products/ Packaged Goods Customer Strategy Database/CRM Digital Marketing Direct Marketing Global Marketing Marketing Communications Marketing Research Mobile Marketing Product Marketing Retail Marketing Sales Social Media Strategy Other Which best describes your main reason for joining AMA? (SELECT ONE) Local chapter events/activities National conferences/training Local networking National/global networking Member-only content (website/publications) Get involved with the local chapter Joined with national event registration Certification/Online Learning Resume builder Communications Preferences I want to receive the following email notifications about important AMA products and services (check areas of interest below) AMA Online Weekly Digest — The latest online content including webcasts, AMA TV, virtual events & podcasts. Professional Development — Information on key events to boost your marketing knowledge & career. Webcasts — Information on free webcasts focused on the hottest topics in marketing. Membership Benefits — Essential announcements and news about your AMA membership. Career Center — Information and updates about marketing jobs and career news. Academic Announcements — Teaching, research and service resources for today’s marketing academics. Your Opinion Counts — Occasional surveys to get your voice heard on critical marketing topics. Do not include me in the AMA member directory. eNewsletter Preferences Marketing News Weekly — This week’s marketing news, insights and commentary. Marketing Academic — Events, journal features, and academic community highlights. B2B Marketing — News and information tailored to business marketers’ needs. AMA Jobs — Featured marketing positions from AMA’s Job Board. Career Update — Career resources and information to help you launch your career. Collegiate Connections — Important chapter announcements, collegiate division updates & best practices. Marketing Health Services — Covering the latest marketing strategies, insights and best practices in health care. Marketing Insights — Driving informed decisions and business value through analytics. The AMA Journal Reader — Short essays summarizing key insights from topics covered in AMA Journals. 1-2017 Page 2 Membership Application Form Group Membership Preferences Publications Complimentary: In addition to Marketing News, one publication of your choice is included in your membership. Please select one. Additional Publications: You may also subscribe to additional print and online publications at the discounted rates below. *If you prefer to have your publications in print and mailed to you, add the international postage fee to each publication. Publications by Pricing Tier Complementary Additional Journal of Marketing (Bimonthly) $90$ Journal of Marketing Research (Bimonthly) $90$ Journal of International Marketing (Quarterly) $80$ Journal of Public Policy & Marketing (Semiannually) $65$ *Additional fees charged for print publications. Additional Publications Subtotal (if applicable) $ For Academic Applicants Only Special Interest Groups (SIGs) (for academic applicants only; select 1 SIG to be included with your membership) Consumer Behavior Doctoral Students Entrepreneurial Marketing Global Marketing Innovation, Technology and Interactivity Interorganizational Marketing and Society Marketing Communications Marketing Research Marketing Strategy Relationship Marketing Retail and Pricing Selling and Sales Management Services Marketing Sports and Special Events Marketing Teaching and Learning Additional Special Interest Groups One SIG is included in your membership. You may join additional SIGs for $20 each. $20 X Number of additional SIGs Academic Division (if applicable) Check here to allocate your local chapter dues to the Academic Division. The Academic Division fosters and supports both the interests of the overall discipline and of Special Interest Groups (SIGs). = $ Statement of Ethics (REQUIRED; PRINT FORM AND SIGN) As an AMA member, I agree to abide by the AMA Statement of Ethics, embracing the highest ethical norms and values for marketers. (1) Marketers must first do no harm. (2) Marketers must foster trust in the marketing system. (3) Marketers should embrace, communicate and practice the fundamental ethical values that will improve consumer confidence in the integrity of the marketing exchange system. Any AMA member found to be in violation of the Statement of Ethics may have his or her Association membership suspended or revoked. A complete copy of the AMA Statement of Ethics is available online at AMA.org. In order to validate your application, please sign the Statement of Ethics. I subscribe to the Statement of Ethics and will adhere to it: Signature______________________________________________ Date _____________ Return your complete form to: American Marketing Association • 130 E. Randolph St., 22nd Floor • Chicago, IL 60601-6320 • Phone: 312.542.9000 or 1.800.AMA.1150 • Fax: 312.542.9001 • AMA.org 1-2017 Page 3