1. What is the name of your company? Company Name: 2. Please fill out contact information: Name: Profession/Title: E-Mail Address (required): Phone (day): Phone (evening): Fax: 3. Please fill out mailing address information: Street Address: City: State: ZIP Code: 4. At which level of membership would you like to join CQCM/Kids First!®? Membership Types (click one) Annual Membership Fees INDEPENDENT PRODUCER MEMBER $150 INDEPENDENT PRODUCER MEMBER RENEWAL (NO LAPSE) $50 5. My company is a(n): Independent Producer Independent Distributor Major Studio Major Distributor 6. What type of company are you?  CD Producer        Telecommunications Company       CD Distributer       Television Producer    Child Advocacy Organization      DVD Producer  Videogame Producer   DVD Distributor Videogame Distributor  DVD Duplicator     Mail Order Company    Other:          7. Please tell us more about your business.     8. Do you have any questions about KIDS FIRST! or the Coalition for Quality Children's Media?       Yes, I would like to subscribe to the free monthly KIDS FIRST! E-zine.   When you are finished, please click the submit button below. If you have applied for corporate membership or sponsorship, we will contact you when your application is received. Please click the button only once, sometimes it takes up to a minute to process the form: