UTV Global Media Network Membership Application

   

Member Information

 

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Items marked with the * are required fields.

 

State which TV Show in our UTV Network you are supporting.

      (your own show or a UTV Media Network show) Click here for a list of UTV Media Network Shows

If you cannot make a selection now write NA in the box.

*

 

 

Your Company or Organization (mark NA in the box if no company at this time):

*

 

 

Referring Affiliate ID: * Referrer's Name: *

 

 

Your Last Name:  *     Your First Name: *

 

 

Street Address:   *

 

City: *         State: *              Zip: *

 

Best Contact Number: *       Telephone 2: 

 

Email Address:  *

 

Student     Retired       Senior Citizen    Unemployed    Self Employed

Employed  If yes, state occupation:        

*  I am 18 and over

I need to set up my website upon signing up as a UTV member

I need more information about UTV web hosting services.

List your areas of interest:

 

 

*

*                                              *  

 

(A representative will contact you shortly to complete your application.)

 

PLEASE NOTE: A portion of your membership fee may go towards a community project and a separate transaction listing will be shown on your monthly statement.  

Click here for information on current community project.

 

MEMBERSHIP:

1)

I hereby apply for membership as an member in the UTV Global Media Network and, if accepted, agree to abide by all the rules and policies set forth by the organization. Further, I certify that the foregoing information is correct.

 

2)

I also understand that the organization has the right to cancel my membership after reviewing my application with a full refund

     of all payments made.

 

3

I also understand that the full setup/application fee must be paid and membership fee in part or in full for the first year

     must be paid before my membership can be activated.

 

4)

I also understand that my membership is automatically renewed after 1 year unless I request cancellation of my

     membership in writing.

 

5)

I also understand that the organization has the right to cancel my membership at any time for any reason, and that the

     membership fee will be refunded on a pro-rata basis, the one-time setup application fee is non-refundable.

 

6)

I also understand that I have the right to cancel my membership at any time for any reason, and that the

     membership fee will be refunded on a pro-rata basis, the one-time setup application fee is non-refundable.

 

 

*I agree to become an UTV Global Media Network Member and to abide by the policies.

I understand that a portion of my membership would go directly to outreach project.

 

 

 

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