NCCTA Membership Application

We hereby apply for membership in the North Carolina Cable Telecommunications Association (NCCTA) and agree to abide by the NCCTA By-Laws.
Membership Type:
Contact Information:
Name:
Title:
Phone: Fax:
Email:
System/Company:
Address:
City: State Zip:

This section to be completed by REGULAR MEMBERS ONLY:

Specify the number of subscribers in 2012:
Enter your Dues amount calculated at .45 cents per subscriber:
Area Served:
Location of Head-end:

This section to be completed by ASSOCIATE & AFFILIATE MEMBERS ONLY:

Nature of Business:
 
NOTE:
Contributions or gifts to the North Carolina Cable Telecommunications Association are not tax deductible as charitable contributions.
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