Magazine Application

Name of Magazine*

Name of Publisher*

Email of Publisher*

Your email is required to process your membership. You will also receive our monthly e-newsletter and occasional email notifications of AMPA events, news and information about your membership benefits and services. Your contact information will remain confidential.

Name of Editor*

Email of Editor*

Name of parent company or association:

Magazine mailing address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Magazine Phone Number:

Magazine Fax Number:

Magazine Website:

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Membership Application

Step 1 of 6

Distribution methods

Digital Magazine Application