MAIS ASSOCIATE APPLICATION FORM

Application Form for Associate Membership

Contact Information as you would like it to appear in the Directory
Name of organization applying for membership
Name of Chief Executive
Title of Chief Executive
Company Contact Name
Title of Company Contact
Company Contact Email
example@example.com
Contact Email to Process Membership Application (if different then above)
example@example.com
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Website
Brief Description of Services and Products offered by Applicant
Please describe how MAIS may assist you
Upload Organization Logo to be used on the MAIS website

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I hereby apply for membership in MAIS, subscribe to its mission, Charter and Bylaws as most recently amended, and confirm our understanding of the responsibilities of membership and pay annual dues.The fee is $500 USD
Signature

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MAIS Web: www.mais-web.org Fax: +(34) 91 352-7795 E-Mail: shannon@mais-web.org
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Application Form for Associate Membership