membership application form Name Applicant Stations Name and on air identification * Contact Person or Individual Members Name * Phone * Email * Fax Mobile * Skype Name MSN Name Web Address Other internet based Contacts i.e Facebook Postal Address * Elected Delegate to SCMA * Proxy Delegate to SCMA * We the station named above make application to the Southern Community Media Association for membership and representation on the SCMA Committee. We understand that we must abide by the rules and code of conduct of the SCMA and accept the rulings of the executive committee to be final in times of dispute. We are a fully Licensed Station / Aspirant Group and have enclosed our payment of $75-00 membership to the association. I wish to be an individual member of the association and have enclosed payment of $50-00 membership to the association. N.B if applying for individual Membership please write * I/We Agree Print Name * Position * I am authorised by the committee of management to make application for membership to the Southern Community Media Association. * I/We Agree and this acts as a signature