APPLICATION FOR ASSOCIATE MEMBERSHIP

 

 

Company Name _____________________________ Web Site__________________________

 

Would your company like a FREE direct link to TTA's Web site? ___ Yes ___No

 

Primary Contact

Name ______________________________________ Title ______________________________

Mailing Address______________________________ City/State/Zip_______________________

Street Address_______________________________ City/State/Zip_______________________

Phone ___________________ Fax ______________ E-Mail_____________________________

 

Additional Contact(s)

Name ______________________________________ Title ______________________________

Mailing Address______________________________ City/State/Zip_______________________

Street Address_______________________________ City/State/Zip_______________________

Phone ___________________ Fax ______________ E-Mail_____________________________

 

Name ______________________________________ Title ______________________________

Mailing Address______________________________ City/State/Zip_______________________

Street Address_______________________________ City/State/Zip_______________________

Phone ____________________ Fax ______________ E-Mail____________________________

 

 

 Please indicate the three (3) principle services or products your company provides to the telecommunications industry.
 

q Access Services

q Accounting

q Advertising

q Billing & Collection

q Broadband Transmission Systems

q Brokers

q Business Appraisers

q Cable TV

q Carrier Equipment

q Cellular

q Central Office Equipment

q Centrex Systems

q CLEC

q Communications Equipment

q Computer Hardware

q Computer Software

q Conference Calling Services

q Construction

q Consulting

q Data Processing

q Database Management

q Direct Broadcast

q Directory Publisher

q Distributor

q EF&I Services

q Engineering

q Fiber Optic

q Financial

q Information Management

q Insurance

q Inter-exchange

q Internet

q ISDN Products

q Legal/Regulatory

q Manufacturer's Representative

q Mapping

q Marketing/Public Relations

q Mobile Communications

q Network Design/Construction

q Paging Systems

q Pay Telephones

q Personal Communication Services

q Prepaid Calling

q Printing/Publishing

q Protective Equipment

q Safety Tape/Markers

q Satellite TV

q Telemarketing

q Test Equipment

q Training/Educational

q Video Conferencing

q Voice Mail Messaging

q Wireless Communications

 

q Other ____________________________________________________________________________

 

ASSOCIATE MEMBERSHIP CATEGORIES

Associate member dues are billed on a calendar year basis (January-December) according to these categories:

 

___Local (One corporate location, whether in Texas or another state) ...................... ..$350

___State or National (Multiple locations operating in Texas and other states)............$650


Description of products sold or services provided (please limit to 25-30 words):

______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________

 

 

METHOD OF PAYMENT

(Make checks payable to the Texas Telephone Association.)

 

___ Cash ___ Check ___ Visa ___ MasterCard ___ American Express


If paying by credit card, please fax this form to:
Richard Walters, Director of Member Services at 512/472-1293

(Thanks. We do not currently accept credit cards via this website.)