Membership	New Membership Membership Renewal Change of Details
Duration of Membership	US$100 for membership to the end of 2012 US$150 for membership to the end of 2013 US$200 for membership in arrears for 2011 plus to the end of 2014 US$200 for membership to the end of 2014
Business Name
Contact Person	Title Select Mr Mrs Ms Dr Rev Name Position
Address
City
State
Zip
Country
Phone
Fax
Cell Phone
Other Phone
Email
Web Site
Do you wish to be on a list of members in our website?	Yes No
Do you wish to receive regular emails and mailers on matters relating to the IDDA?	Yes No
Comments
The following information is optional but useful for statistical purposes and knowing your interests:
Does your organisation do any of the following in-house (not sub-contracted out)
Do CD-R Duplication	Yes No	Offer Thermal Printing	Yes No
Offer Inkjet Printing	Yes No	Print onto adhesive labels	Yes No
Print Case Inserts yourself	Yes No	Do Customized Packaging	Yes No
Offer a Design Services	Yes No	Offer Shaped Discs	Yes No
Do your own CD Replication	Yes No	Do your own Screen or Offset Printing	Yes No
Do your own DVD Replication	Yes No	Contract out DVD replication	Yes No
Convert Video to Disc	Yes No	Duplicate VHS tapes	Yes No
Duplicate/Master Audio tapes	Yes No	Offer Disc Quality Analyzing	Yes No
Offer Fulfillment Services	Yes No	Sell Disc Duplicators	Yes No
Manufacture Disc Duplicators	Yes No	Distribute Blank Disc Media	Yes No
Distribute Labels / Cases, etc	YesNo	Offer Copy Protection	Yes No
Other information about your organization
I have read and subscribe to the ethical standards of the IDDA:		Yes No
Payment of US $100 covers membership to the end of December 2012. or US$150.00 to the end of December 2013. Take advantage of our special offer and save us and yourself extra bookwork and cost by paying $200 for membership for 2012, 2013 and 2014. Payment must be tendered before membership can be accepted There are three ways to pay. 1. Amex, Visa and Mastercard Credit card (with secure transfer via PayPal's web site) 2. Fax credit card details 3. PayPal Reload Image Enter the code visible on your screen (or click the audio icon to hear the code), then click "Next" to submit the information entered so far and use one of the four payment options.