Type of Membership:

 New Member           Renewal

Company 

Mail address

City, State/Province

Zip/Postal code

Country

Web address

Parent Corporation

Number of employees at this location  

Number of affiliated contact centers 

Number of contact center employees at other locations

Location (city/country) of affiliated contact centers

Type of products or brands your organization represents*

Primary Representative for your Company:

Individual’s name

Job title

What category best describes your current position Staff Member Manager Vice President/Director Executive

Email

Phone

Fax
Register this person now for the 2010 conference at $645 if purchasing a membership. This represents a savings of $50 off regular conference registration fees! (see membership options below)

Maximize your membership benefits by adding additional contacts to receive information from IARE.

Please include contact information for employees of member location only:

1. Name
   Job Title
   What category best describes this person Staff Member Manager Vice President/Director Executive
   Email
   Phone
   Register this person now for the 2010 conference at $645 if purchasing a membership. This represents a savings of $50 off regular conference registration fees!
    

2. Name
   Job Title
   What category best describes this person Staff Member Manager Vice President/Director Executive
   Email
   Phone
   Register this person now for the 2010 conference at $645 if purchasing a membership. This represents a savings of $50 off regular conference registration fees!
    

3. Name
   Job Title
   What category best describes this person Staff Member Manager Vice President/Director Executive
   Email
   Phone
   Register this person now for the 2010 conference at $645 if purchasing a membership. This represents a savings of $50 off regular conference registration fees!
    

4. Name
   Job Title
   What category best describes this person Staff Member Manager Vice President/Director Executive
   Email
   Phone
   Register this person now for the 2010 conference at $645 if purchasing a membership. This represents a savings of $50 off regular conference registration fees!
    

5. Name
   Job Title
   What category best describes this person Staff Member Manager Vice President/Director Executive
   Email
   Phone
   Register this person now for the 2010 conference at $645 if purchasing a membership. This represents a savings of $50 off regular conference registration fees!

If you would like to add more contacts and register them for the 2010 conference, please add information in the comments field below.

Membership Options:
Select a membership option below Principal Member (100+ employees) $500 US Principal Member (100+) Package $1,145 includes one 2010 Conference registration Principal Member (less than 100 employees) $300 US Principal Member (less than 100 employees) Package $945 includes one 2010 Conference registration

Total Amount Due $
        Remember to add all conference registrations
( noted above at $645) to the contact center dues amount.

Payment Method 

IARE Tax ID # 47-0690031
Funds must be payable in U.S. funds drawn on a U.S. bank.

VISA American Express MasterCard Check payable to "IARE"

Cardholder's name:
Card number:      Expiration: 

First-time membership dues accepted after October 1st will cover membership through the end of the next calendar year.

Name and company name of person who referred you to join IARE:

Comments: