THE OLDEST NEWS PHOTOGRAPHERS ASSOCIATION IN THE UNITED STATES – BOX 51477 BOSTON, MA 02205 APPLICATION FOR MEMBERSHIP (PLEASE PRINT OR TYPE) DATE NAME HOME ADDRESS CITY STATE EMPLOYER ADDRESS CITY STATE D.O.B. PHONE ZIP CODE PHONE ZIP CODE PLEASE CHOOSE THE TYPE OF MEMBERSHIP FOR WHICH YOU ARE APPLYING. For a despcription of membership types, please read the BPPA ByLaws found online at www.bppa.net/downloads ____ Full Membership _____ Honorary Membership _____ Student Membership _____ Life Membership PROFESSIONAL REFERENCES (For full and student memebership only. Students need only one professor for reference. Full memebership applicants should include a reference with whom they have worked.) NAME CONTACT INFORMATION AFFILIATION NAME _________________________________________ AFFLIATION ____________________________ CONTACT INFORMATION -____________________________________________ IS THIS AN APPLICATION FOR REINSTATEMENT? YES NO APPLICANT’S SIGNATURE A CHECK FOR $60.00 PAYABLE TO BPPA MUST ACCOMPANY THIS APPLICATION CHECK RECEIVED MEMBERSHIP COMMITTEE BOARD OF DIRECTORS RECOMMENDED YES NO ASSOCIATE [ 72 ] boston press photographers association