NACM Great Lakes

MEMBERSHIP FORM

NACM Great Lakes Membership Form

Firm Name:
Company Rep:		*Business Address if Different from left.
Title:
Address:		Address:
City:		City:
State:		State:
Zipcode:		Zipcode:
Phone:		Services
Phone:		(Select membership option(s))
Fax:		Full Membership - $395.00 Associate Membership - $150.00 Small Business Membership - $150.00
E-mail:
NACM Rep:
Date of membership:		# of members:
Business Classification:		Annual Billing:
SIC Code:




To the Board of Directors: We hereby make application for membership in the National Association of Credit Management and pledge ourselves to observe the by-laws and rules of the Association and further its objectives as far as possible. All dues and services are payable annually in advance and continuing from year to year, unless notice of cancellation is given at least thirty days in advance of any expiration date.

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� 2006 NACM Great Lakes	An Affiliate of National Association of Credit Management