VALLEY BROADCAST LEGENDS
MEMBERSHIP APPLICATION

Join the Central Valley’s broadcasters’ club .

Memberships:  $25 dues. Must have 10 or more years in Broadcasting &/or related fields.

Memberships run from Jan. 1st to Dec. 31st. New members joining in the 2nd half of the year may pay
		$15. All applications are subject to approval by the Board of Directors.

Date of application:  Month               Day              Year            _

NAME:

ADDRESS:  (# street, city, zip)

PHONE:			CELL PHONE:			WORK PHONE:

E-MAIL:

Name of member who invited you to join (if any):                                                                     .

AFFILIATION(s): What station(s) did you work at, during what years, and what title(s) did you hold? 

						(continues over) 					(1Aug24)

Broadcast industry awards

Career highlights from your years in broadcasting. 

If you left broadcasting before retirement, what did you do afterwards?

What are you doing now?

Return completed form with your dues check to:
Valley Broadcast Legends
P.O. Box 601861
Sacramento, CA. 95860-1861