Member Application

Business Information

Company Name: *

Phone: *

Website:

Directory Category: *

Comments / Questions:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Primary Contact Information

First Name: *

Last Name: *

Title:

Email: *

Password: *

Membership Options

Membership Package: *

Silver: $650.00
Package Includes: Event Postings, News @ 8 Press Release System, Committee participation, Educational Savings and Seminars, 1 reservations per year in the Woodward Auditorium and 2 reservations per year in any Conference Rooms. Gold: $1,500.00
Package Includes all Silver benefits plus: Host a Morning Member Mingle, Event Promotion, 2 reservations per year in the Woodward Auditorium and 4 reservations per year in any Conference Rooms. Gold: $1,500.00
Package Includes all Silver benefits plus: Host a Morning Member Mingle, Event Promotion, 2 reservations per year in the Woodward Auditorium and 4 reservations per year in any Conference Rooms. Platinum: $2,500.00
Package Includes all Gold benefits plus: Host a Tech Takeover ($1,000 value), 2 reservations per year in the Woodward Auditorium and 6 reservations per year in any Conference Rooms. Diamond: $5,000.00
Package Includes all Platinum benefits plus: Complimentary Integr8™ sponsorship (half-page program ad, $500 value), 4 reservations per year in the Woodward Auditorium and 8 reservations per year in any Conference Rooms.

Payment Option:

Bill me Charge my credit or debit card

In the effort to fight spam, please provide the answer to the following question.

What is the sum of 1 plus 6?: *