By my signature below and on behalf of the person or entity so indicated herein, for whom I have all necessary authority to act, I hereby make application to join the Association, Small Business in Telecommunications, which is a non-profit trade association. I understand and agree that this application shall not be deemed effective unless and until I have paid annual membership dues of $300.00 as have been set by the Board of Directors, in accord with the bylaws of the association.
As a member of Small Business in Telecommunications, I understand that I will be bound by the bylaws of the Association, including without limitation all bylaws related to my ability to vote on Association matters and serve as an officer or director of the Association.
Once this application is accepted, I understand that I shall be entitled to all of the rights and benefits of membership which exist or which shall exist in accord with the bylaws of the Association. The term of my membership shall be dependent on my continued participation in the Association in accord with the bylaws, including the payment of dues.
Therefore, in accord with the foregoing, I hereby make application for membership in Small Business in Telecommunications.
| ________________________________________________ Applicant's Signature . |
____________________ Date . |
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| _____________________________________________________________________ Please Print Applicant's Name (& Company name if applicable) . |
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| _____________________________________________________________________ Applicant's Address . |
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| __________________________________________ City . |
___________ State . |
_______________ Zip . |
| (____)_______________ Telephone Number | (____)_______________ Facsimile Number |
____________________________ E-mail Address |
I am applying to be a ____Voting member/____ Associate member (check one), in accord with the bylaws of the Association.
I am applying as an ____Individual/____ Company (Check one).
Method of Payment (Circle one): Cash - Check - Visa/Mastercard - Bill Me
Account Number: ___________________________________ Exp. Date: _________
Signature: _________________________________________ Date: ___________
Please fax to (202) 347-8607
All applications must be completed, in full, to create eligibility
to join SBT. SBT reserves the right to revoke membership of any person who creates
a misrepresentation in the completion of this application.