Membership Application:

[GO BACK]

Membership application

I submit the following information so that the Admissions Committee may consider my qualifications.

Date
MM slash DD slash YYYY
Name*
Email*
Employer (if you are applying for a Student membership, enter the name of your college/university)*
Job Title*
Freelancer Information*
If you are NOT a freelancer, please just enter NA. If you are a freelancer, please include links to at least three examples of your work. If you face a hardship in paying OPC dues, write a short paragraph here explaining why the Membership Committee should consider giving you some financial aid from the OPC’s Freelancer Fund.
Date of birth(mm/dd/yyyy)*
MM slash DD slash YYYY
Home Address*
Home Address City*
Home Address State, Province or Region (And country if non-U.S.)*
Home Address Zip Code*
Business Address (Street, State, Zip Code, Country)*
Please enter your complete business address on one line. If your business address is the same as your home address, please just enter "Same as home address."
City where you are curently based*
State / province / region where you are currently based*
Zip Code where you are currently based*
Country where you are currently based*
Business Phone*
Home Phone
Cell Phone
I want to receive OPC mail*
- at my home
- in the office
PROFESSIONAL REFERENCE: List TWO OPC members or someone familiar with your work:
Professional Reference Name (#1)*
Professional Reference Affiliation and Job Title (#1)*
Freelancer Reference Information (#1)
If your professional reference is a freelancer, please tell us their main strings - broadcasters or publications - and links to a few examples of their work. If your professional reference is not a freelancer, please just enter NA.
Professional Reference's Business Phone (#1) (optional)
Professional Reference Email (#1)*
Professional Reference Name (#2)*
Professional Reference Affiliation and Job Title (#2)*
Freelancer Reference Information (#2)
If your professional reference is a freelancer, please tell us their main strings - broadcasters or publications - and links to a few examples of their work. If your professional reference is not a freelancer, please just enter NA.
Professional Reference's Business Phone (#2) (optional)
Professional Reference Email (#2)*
Your Membership Type is... (fill out form and click "Calculate")*
"Membership Type" is determined by the location where you are based and date of birth. Fill in all of the information in the form and click "Calculate" to generate Membership Type and Membership Fee.
Your Membership Fee is...(fill out form and click "Calculate")*
Fill in all of the information in the form and click "calculate" to generate your Membership Fee. If you encounter any issues with this form, please download and fill out the PDF in the link below, and send it to info@opcofamerica.org. http://opcofamerica.org/wp-content/uploads/2022/09/Membership-Application-PDF_.pdf
Applicant's Signature*

Membership Application:

[GO BACK]

Membership application

PROFESSIONAL REFERENCE: List TWO OPC members or someone familiar with your work: