Membership Application
Please fill in the fields below and someone will contact you regarding your membership.
Date
Name
Nickname
Home Address
City/Zip
Home Phone
Date of Birth
Years Living in Tulsa
Years Working in Tulsa
Spouse's Name
Nickname
Hobbies
Special Interests or Other Organizations
Business Name
Type of Business
Phone
Supervisor/Owners Name
Fax
Business Address
Cellular
City/Zip
Length of Time with Company
Email Address
Years in Same Industry
Company Website
If less than one year, please give previous history
Business Contacts (2)
Description of Business and Your Position
What type of business do YOU call on? (Industrial, Retail, Commercial)
What would be a good LEAD for YOU?
What do you feel YOU can contribute to the TPA?
Any additional information you would like us to know?
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