Oklahoma Technology Association

2009 Membership Application
 All dues are annual and payable by September 1, each year.
View 2008 Member Districts            Home
If paying by Mastercard or Visa, please call Paula Walker at (405) 201-7368

Institutional Associate
Institutional		 Individual Undergraduate Full-Time
Student
Date:       (mm/dd/yyyy)
   Institutional? Check here  
$300 Annually

Educational institutions with multiple representatives. 
All district employees are considered members. 
Copies of mailings will only be sent to 5 specified individuals. 

Institution Name:    
Address:    City:State Zip
 
  1. Member 1 Information: (Designated voting member)
    Name:      Site: 
    Address:      City:State: Zip:
    Phone:        Fax: 
    Email Address:       
     
  2. Member 2 Information:
    Name:  Site: 
    Address:      City:State: Zip:
    Email Address: 
     
  3. Member 3 Information:
    Name:  Site: 
    Address:      City:State: Zip:
    Email Address: 
     
  4. Member 4 Information:
    Name:  Site: 
    Address:      City:State: Zip:
    Email Address: 
     

  5. Member 5 Information:
    Name:  Site: 
    Address:      City:State: Zip:
    Email Address: 

    If paying by PO, please list PO # here: 
    Click Submit to complete application and view additional payment options.