_______________________________________________________________________________________
Full Name
_______________________________________________________________________________________
Title Company/Firm
_______________________________________________________________________________________
Street Address
_______________________________________________________________________________________
City State/Province ZIP/Postal Code Country
_______________________________________________________________________________________
Phone Fax
_______________________________________________________________________________________
E-mail (business) E-mail (personal)
_______________________________________________________________________________________
Web site
Are you new to TMA? o Yes o No (Enter ID#, if known) _______________
How did you hear of TMA? __________________________________________________________________________
Turnaround Management Association
Dedicated to Corporate Renewal
TMA Membership Application
Page 1 of 2
Optional (check all that apply)
o
INSOL Special Interest Group $ 140 USD/year
Annual membership of INSOL, International Association of Insolvency, Bankruptcy
& Restructuring Practitioners. Includes quarterly journal
INSOL World
, technical
electronic newsletter, event discounts and Membership Directory Listing.
Learn more at insol.org.
o Cornerstone Donation $________USD
To learn more about the Cornerstone endowment campaign, visit
turnaround.org/about/cornerstone.aspx.
Demographic Information
Please provide demographic data to help TMA provide educational and networking
programs to t your needs.
Year Born:
____________________
Diversity Programming Interests
o Women’s Professional Networking
o Young Professional
o Minority or Ethnically Diverse
Membership Category (check one)
o
Member $350 USD
o Young Professional
(New Members, 35 & under)* $175 USD
o Government/Academic** $125 USD
o Full-Time Student*** $75 USD
Dues and application are valid for one year.
Memberships are on an individual basis only, are
non-transferable and non-refundable.
* Young Professional applicants must be new members
age 35 and under at the time of application. Discount is
available for a total of two years or until the age of 36.
Copy of a government issued ID is required. Existing TMA
members are not eligible.
** Government/Academic applicants must be a current
employee of a government, judicial or academic
institution. Applications are subject to approval and
supporting documentation may be required.
*** Full-Time Students must submit documentation verifying
their current enrollment in a graduate or undergraduate
program at an accredited university. Please contact TMA
for details.
Continued on next page
Gender o Male o Female
o Prefer not to answer
o Alabama
o Arizona
o Atlanta
o
California [Northern]
o California [Southern]
o Canada [Montreal]
o Canada [Toronto]
o Carolinas
o Central Texas
o Chesapeake
o Chicago/Midwest
o Connecticut
o Dallas/Ft. Worth
o Detroit/Grand Rapids
o Florida
o Houston
o Long Island
o Louisiana
o Minnesota
o Missouri
o Nevada
o New Jersey
o New York City
o Northeast
o Northwest
o Ohio
o Philadelphia
o Pittsburgh
o Rocky Mountain
o Tennessee
o Upstate New York
o International
Preferred Chapter (check one)
v. 1-2015
