Oklahoma Invoice Template Page 3
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OKLAHOMA TELEPHONE ASSOCIATION
ASSOCIATE MEMBER
INFORMATION AND DATA SHEET
The information below will reflect how your company is listed in the 2015 Oklahoma
Telephone Association Directory. Please type or print.
Company Name:
_____________________________________________________
Street Address:
_____________________________________________________
Mailing Address (if different than above): _____________________________________
City:
________________________ State __________ Zip _______________
Telephone: Area Code: _____ Telephone #: ______________________
FAX #:
Area Code: _____ Telephone #: ______________________
e-mail:
_________________________________________________
web address: ________________________________________________
OTA Contact Person (or persons) you want listed in the OTA Directory (limit 2)
Name:
__________________________________________________________
Address:
__________________________________________________________
City:
________________________ State __________ Zip _______________
Telephone: Area Code: _____ Telephone #: ______________________
FAX #:
Area Code: _____ Telephone #: ______________________
e-mail:
______________________________________________________
Name:
__________________________________________________________
Address:
__________________________________________________________
City:
________________________ State __________ Zip _______________
Telephone: Area Code: _____ Telephone #: ______________________
FAX #:
Area Code: _____ Telephone #: ______________________
e-mail:
______________________________________________________
Additional contact (for e-mail notifications only)
Name:
_________________________________________________________
e-mail:
_________________________________________________________
Telephone
Area code:_________
Telephone #: _____________________
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