ASSOCIATE MEMBER DUES: BUSINESS INFORMATION: COMPANY ...
2017 ASSOCIATE MEMBERSHIP APPLICATION Energy Council of the Northeast P.O. Box 1029 Windham, NH 03087
ASSOCIATE MEMBER DUES:
Industry Partners (i.e. contracting and consulting firms, manufacturers, manufacturer's representatives, etc.) are eligible for ECNE's Associate Membership. Associate Membership is by individual, for the calendar year (January – December), at the rate of $490/year for the first member, $250/year for each subsequent member from the same company.
BUSINESS INFORMATION:
(Please complete individual applications for each additional membership requested). NAME: __________________________________________________________________________________________ JOB TITLE: _______________________________________________________________________________________ COMPANY: ______________________________________________________________________________________ ADDRESS: _______________________________________________________________________________________ CITY:_____________________________________ STATE: _______________ ZIP CODE: _____________________ WEB SITE: _______________________________ E MAIL ADDRESS: _____________________________________ TELEPHONE #: __________________________________ FAX #: _________________________________________ Is the above business information listed the way you’d like to be listed in our Member Directory? If not, please list the information on the reverse.
Please mark the category that best describes your company: Architectural/Engineering Contractor Manufacturer Business Management Educational Facility Manufacturers’ Representative Consultant Distributor Supplier Other: _______________________________________________________________________________________
COMPANY DESCRIPTION:
For your listing in the Directory and in our database, please supply a 45 - 100 word company description. We will use this information in our directory and for your member listing on our web site. Feel free to submit this on another sheet of paper. _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Please see next page. ENERGY COUNCIL OF THE NORTHEAST * WINDHAM, NH 03087 ' (603) 626-4602 ! (603) 626-4605 : WWW.ECNE.ORG
COMPANY ADVERTISEMENT:
As part of your Associate Member Benefits, ECNE includes your FULL COLOR ad, (8 ½ x 11 inches) in our Industry Partners Directory. There is NO ADDITIONAL FEE for this advertisement! Please submit your company advertisement to [email protected]. Advertisements should meet the following specifications: • • • •
Full Color Full Page (8.5 x 11) No Bleed or Markup JPEG or PDF Preferred (Also accepted are TIF or any MS Office Suite (Word, PowerPoint, etc.)
DIRECTORY LISTING:
If you would like different contact information printed in the directory and listed on the web site (other than your contact info from the front), please include it here: COMPANY: ______________________________________________________________________________________ ADDRESS: _______________________________________________________________________________________ CITY:_____________________________________ STATE: _______________ ZIP CODE: _____________________ WEB SITE: _______________________________ E MAIL ADDRESS: _____________________________________ TELEPHONE #: __________________________________ FAX #: _________________________________________ I hereby apply for Associate Membership within the Energy Council of the Northeast and enclose payment to cover each assessment of dues as stated above. Signature: ______________________________________________________________ Date: ___________ / __________ / __________
Please return this application by: Mail: Energy Council of the Northeast P.O. Box 1029 Windham, NH 03087 E-Mail:
[email protected]
Fax:
(603) 626-4605
PAYMENT INFORMATION:
To be compliant with PCI Data Security Standards, we cannot accept credit card information by fax or email. To pay by credit card, please call our office at (603) 626-4602 to process your payment over the phone. A receipt is automatically generated and sent to you by Authorize.net. To pay by check, please make the check payable to the Energy Council of the Northeast, and mail to:
ENERGY COUNCIL OF THE NORTHEAST * WINDHAM, NH 03087 ' (603) 626-4602 ! (603) 626-4605 : WWW.ECNE.ORG
Energy Council of the Northeast PO Box 1029 Windham, NH 03087
ENERGY COUNCIL OF THE NORTHEAST * WINDHAM, NH 03087 ' (603) 626-4602 ! (603) 626-4605 : WWW.ECNE.ORG
ASSOCIATE MEMBER DUES:
Industry Partners (i.e. contracting and consulting firms, manufacturers, manufacturer's representatives, etc.) are eligible for ECNE's Associate Membership. Associate Membership is by individual, for the calendar year (January – December), at the rate of $490/year for the first member, $250/year for each subsequent member from the same company.
BUSINESS INFORMATION:
(Please complete individual applications for each additional membership requested). NAME: __________________________________________________________________________________________ JOB TITLE: _______________________________________________________________________________________ COMPANY: ______________________________________________________________________________________ ADDRESS: _______________________________________________________________________________________ CITY:_____________________________________ STATE: _______________ ZIP CODE: _____________________ WEB SITE: _______________________________ E MAIL ADDRESS: _____________________________________ TELEPHONE #: __________________________________ FAX #: _________________________________________ Is the above business information listed the way you’d like to be listed in our Member Directory? If not, please list the information on the reverse.
Please mark the category that best describes your company: Architectural/Engineering Contractor Manufacturer Business Management Educational Facility Manufacturers’ Representative Consultant Distributor Supplier Other: _______________________________________________________________________________________
COMPANY DESCRIPTION:
For your listing in the Directory and in our database, please supply a 45 - 100 word company description. We will use this information in our directory and for your member listing on our web site. Feel free to submit this on another sheet of paper. _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Please see next page. ENERGY COUNCIL OF THE NORTHEAST * WINDHAM, NH 03087 ' (603) 626-4602 ! (603) 626-4605 : WWW.ECNE.ORG
COMPANY ADVERTISEMENT:
As part of your Associate Member Benefits, ECNE includes your FULL COLOR ad, (8 ½ x 11 inches) in our Industry Partners Directory. There is NO ADDITIONAL FEE for this advertisement! Please submit your company advertisement to [email protected]. Advertisements should meet the following specifications: • • • •
Full Color Full Page (8.5 x 11) No Bleed or Markup JPEG or PDF Preferred (Also accepted are TIF or any MS Office Suite (Word, PowerPoint, etc.)
DIRECTORY LISTING:
If you would like different contact information printed in the directory and listed on the web site (other than your contact info from the front), please include it here: COMPANY: ______________________________________________________________________________________ ADDRESS: _______________________________________________________________________________________ CITY:_____________________________________ STATE: _______________ ZIP CODE: _____________________ WEB SITE: _______________________________ E MAIL ADDRESS: _____________________________________ TELEPHONE #: __________________________________ FAX #: _________________________________________ I hereby apply for Associate Membership within the Energy Council of the Northeast and enclose payment to cover each assessment of dues as stated above. Signature: ______________________________________________________________ Date: ___________ / __________ / __________
Please return this application by: Mail: Energy Council of the Northeast P.O. Box 1029 Windham, NH 03087 E-Mail:
[email protected]
Fax:
(603) 626-4605
PAYMENT INFORMATION:
To be compliant with PCI Data Security Standards, we cannot accept credit card information by fax or email. To pay by credit card, please call our office at (603) 626-4602 to process your payment over the phone. A receipt is automatically generated and sent to you by Authorize.net. To pay by check, please make the check payable to the Energy Council of the Northeast, and mail to:
ENERGY COUNCIL OF THE NORTHEAST * WINDHAM, NH 03087 ' (603) 626-4602 ! (603) 626-4605 : WWW.ECNE.ORG
Energy Council of the Northeast PO Box 1029 Windham, NH 03087
ENERGY COUNCIL OF THE NORTHEAST * WINDHAM, NH 03087 ' (603) 626-4602 ! (603) 626-4605 : WWW.ECNE.ORG
