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MEMBERSHIP APPLICATION Name: ____________________________________ Designations: __________________________ Title: ____________________________________________________________________________ Organization: _____________________________________________________________________ Address: _________________________________________________________________________ City: ______________________________________ State: __________ Zip: __________________ E-mail: ____________________________________ Phone: _______________________________ MEMBERSHIP CATEGORY: ! Active Member: Since CSPI is all about partnership, we offer a discount when a Convention Center, Destination Marketing Organization and/or headquarter hotel partner join together. ! $285.00 each when a Center, DMO or Hotel join together (includes 2 members) ! $385.00 when a Center, DMO or Hotel joins independently (includes 2 members) ! $135.00 for additional members from the same organization ! Affiliate Member: ! $535.00 for companies that supply goods or services to the convention industry (one individual will represent the company) METHOD OF PAYMENT (US funds and US banks only): ! Check: Amount: ________ " Complete application and email to [email protected] " Mail application with check to: CSPI, PO Box 39, Buck Hill Falls, PA 18323 ! Credit card: Amount: ________ ! Visa ! MC ! AMEX Cardholder Name: ____________________________________________________________ Address (if different than above): ________________________________________________ Account #: _________________________________ Exp. Date: _______ CVV Code: ______ " Complete application with credit card information and email to [email protected] Feel free to contact Stephen Jackson, Membership Chair, with any questions at 919.645.2655 CSPI - www.cspionline.org - [email protected] - 570.871.0818
