I am Renewing my WOMMA Membership as an Industry Partner
	If you are joining WOMMA as a Partner, click here.

Governing Membership - Annual dues fee of $10,000. Companies with a vested interest in advancing the discipline of WOM and the WOM industry.

	Standard Membership - Annual dues fee of $3,000. Brands and industry partners, in and outside of North America, who have 11 or more full-time employees.
	Small Business Membership - Annual dues fee of $1,000. Brands and industry partners, in and outside North America, who have 10 or fewer full-time employees. Small business membership status will be reviewed annually.
	Nonprofit Membership - Annual dues fee of $1,500. Organizations who qualify as a nonprofit institution and can provide proof of nonprofit status.

Primary Contact Information

(*Required Field)

First Name*
Last Name*
Title*
Email*
Twitter
Phone*
Assistant's Name
Assistant's Email

Secondary Contact Information

Secondary Contact Information (For when you’re away. Suggested people: VP, Corporate Comm.; CMO; Marketing Manager)

(*Required Field)

First Name*
Last Name*
Title*
Email*

Company Information

Name*
Website*
Phone*
Fax
Mailing Address*	Street City, State, ZIP, Country
My company is a*	Ad Agency WOM Research Firm Technology/SM Platform Service Provider Media Buyer/Planner PR Firm WOM Consultant Social Media/Digital Agency Other (enter below) Other (please explain)
Briefly explain the product(s) or service(s) your company provides.*
Parent company (if any)
Subsidiaries with separate revenue streams (if applicable)
Has your company profile changed? Let us know 100 words about your company, to be used in our member directory.*
Company logo*
# of full time employees*
Has your staff changed since last year? Upload a new staff list spreadsheet here. (names, job titles, emails, contact info, Twitter handles)

Tell Us About You

Other than WOMMA, my staff belongs to the following organizations...*	AAAA AAF ABA ACC AIGA AMA ANA APALA ARF BMA CMO Council DMA DMMA DSA ERA Forrester Forum One IAB Local Social Media Club MRA PIHRA PMA PRSA SMAC SMBC SOCAP WARC Other (please explain)
My top three WOM/social media education needs are...*	1. 2. 3.
My/my company's goals for WOMMA membership are...*

Legal

WOMMA expects its members (and those companies applying for membership) to set an example of high ethical standards for word of mouth marketing. WOMMA members must adhere to the WOMMA Ethics Code of Conduct, Bylaws, and all other WOMMA policies, rules or regulations. In order to qualify for membership in WOMMA, applicants must not be engaged in word of mouth marketing practices that violate the WOMMA Ethics Code. By joining WOMMA, we demonstrate our commitment to the growth of the word of mouth marketing industry. We affirm that our company supports the highest level of ethical word of mouth marketing practices, and will adhere to the WOMMA Ethics Code of Conduct, Bylaws, and all other WOMMA policies, rules or regulations. Members of WOMMA are to serve the goals of advancing the word of mouth marketing industry, including all commercial platforms that are designed to advance the advertising of products and services, and promoting the integrity of ethical word of mouth as a meaningful vehicle for commercial activity. As a result, WOMMA members shall report to the Membership Ethics Advisory Panel (MEAP) any conduct by another WOMMA member that the member believes violates the WOMMA Code of Ethics and Standards of Conduct. Such reporting shall be in compliance with the procedures set forth by the MEAP.*

Billing

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Please provide the contact information of your Accounts Payable or billing contact person:

Name: Title: Email: Phone:

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Cardholder's Name
Expiration Date
Security Code
Billing Address (if different than Mailing Address)

Pay Via Invoice	An invoice will be automatically generated and emailed to you.
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