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 for the 2010 conference at $645 if purchasing a membership package (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 for the 2010 conference at $645
    

2. Name
   Job Title
   What category best describes this person Staff Member Manager Vice President/Director Executive
   Email
   Phone
   Register this person for the 2010 conference at $645
    

3. Name
   Job Title
   What category best describes this person Staff Member Manager Vice President/Director Executive
   Email
   Phone
   Register this person for the 2010 conference at $645
    

4. Name
   Job Title
   What category best describes this person Staff Member Manager Vice President/Director Executive
   Email
   Phone
   Register this person for the 2010 conference at $645
    

5. Name
   Job Title
   What category best describes this person Staff Member Manager Vice President/Director Executive
   Email
   Phone
   Register this person for the 2010 conference at $645

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 2009 Conference registration Principal Member (less than 100 employees) $300 US Principal Member (less than 100 employees) Package $945 includes one 2009 Conference registration

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: