BOMA Member Information
To collect and assemble member information and keep current
Email address *
Company Name *
Describe your audience (ex. Young, urban music video watchers OR Gospel music fans)
Type of media outlet *
You may select more than one option
If you'd like to include your distribution numbers, readership or listenership, please do so here.
BOMA Contact Person *
Company Website
Should start with http:// or https://
Company Phone Number
Company Email
NOT your personal email address. Please include the company's public email address.
Company Address
A few sentences about this media outlet *
High Resolution Company Logo
This can be a pdf, jpeg, png or other image file type. Should be in print ready resolution.
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This form was created inside of Blondie Ras Productions, Inc. - Terms of Service