AMIN Worldwide :: Membership Profile

Membership Profile

Applications for membership are accepted without commitment on the part of the Network and are subject to review and recommendation by the Executive Committee and approval by a majority of the membership. All information submitted will be held in strictest confidence. Please note that all fields with '*' are required for consideration. Click here for a downloadable PDF application.

  *  Name of Agency  
  *  Telephone  
  Fax  
  *  Address 1  
  Address 2  
  *  City  
  *  State/Province  
  *  Country  
  *  ZIP/Postal Code  
  Agency General E-mail  
  *  Web Site  

*  Official Contacts
* Name * Title * E-mail
 
Branch Office Locations

 
*  When was your agency established?

 
Was there a predecessor agency? Yes
 
If so, give predecessor name and explanation:

 
*  Is your agency a:
   Officers and Partners
Name Title Age Time With Agency
 
*  How many total employees on payroll, including owners?

 
What departments or specialized personnel do you have?
 

What creative/media recognitions and association memberships do you have?

*  How many active clients does your agency serve?
 
*  List your four biggest clients in terms of income to your agency.
* Client Name * How Long Served?
 
*  Approximate percentage of annual income in following media:
* Newspapers %   * Television %
* Radio %   * Magazines %
* Outdoor & Transportation %   * B to B Publications %
* Point of Sale / Promotions %   * Collateral %
* Direct Mail %   * SEO %
* Online %   * Social Media %
 
*  Total capitalized billing (net x 6.6) for last complete fiscal year
$
 
*  Estimated capitalized billing (net x 6.6) for current fiscal year
$
 
Offices held in community organizations or advertising groups
by key agency executives or owners:

*  I attest that the information above is accurate to the best of my knowledge and belief,
and by completing the following fields I am casting my "Digital Signature."
 
* Name * Title * Date