California Copyright Conference

____ INDIVIDUAL   or  ____ CORPORATE MEMBERSHIP

Please print, fill out and remit this form with a check made out to CCC, and send
to: 

	California Copyright Conference 
	P.O. Box 57962
	Sherman Oaks, CA 91413

If you wish to register online, please visit our website at http://www.theccc.org 
For assistance or additional information, please call (818) 379-3312. 

CCC MEMBERSHIP APPLICATION/RENEWAL 
The applicant agrees to abide by the Charter and By-Laws of the CCC and pay the 
required annual membership fee. Annual dues are $55.00 for individuals, or
$250.00 for corporate memberships. All memberships are renewable in July.

Name:     ________________________________________________________
(If this is a corporate membership, please include the name of the contact person.)

Title:    ________________________________________________________

Company:  ________________________________________________________

Address:  ________________________________________________________

City:     ________________________________________________________

State:    _______________________  Zip Code: _____________________

Business Phone: ________________________________________________________

Business Fax:   ________________________________________________________

E-Mail:   ________________________________________________________

Business Website: ________________________________________________________

Email: Do you want to receive email noticies of our meetings and events? ญญญ_________

Please indicate which ONE of the following categories best applies to you: 
__ Music Publisher      __ Record Company 
__ TV/Film Producer     __ Music Supervisor 
__ Music Clearance      __ Attorney 
__ Songwriter/Composer  __ Accountant 
__ Artist               __ Agent 
__ Other
 

Signature: _________________________________________________________________ 
Please sign your name. DO NOT PRINT! 

ฉ 2007 California Copyright Conference 
The California Copyright Conference is a non-profit organization