Application for Corporate Partner Membership

Please select a membership below and confirm acknowledgement of our Code of Ethics and membership in NAPO, if applicable.

All fields in bold are required.

	Corporate Partner Membership	Dues
	PLEASE SELECT ALL THAT APPLY
	I am applying to become a Corporate Partner	$300
	I am renewing my Corporate Partner Membership	$250

Company Information
Company Name:
Corporate Partner Representative:
Title:
Business Address:
City:
State:
Zip:
Website Address:	e.g. - http://www.yourdomain.com
Email:
Business Phone:
Cell Phone:
Other Phone:
Fax:

Check here to authorize NAPO-WDC to list your information on its website

How did you hear about NAPO-WDC?
Were you ever a NAPO member?	Yes No
Were you ever a NAPO-WDC member?	Yes No
What is your primary reason for joining NAPO-WDC?

Company description / message to be displayed on the NAPO-WDC website (50 words or less): Note: This is will be visible to the public. NAPO–WDC reserves the right to edit text for publication on the NAPO-WDC website.
Please describe the products or services your organization represents:

Free Services Available

I would like a static company logo listed by my company’s name on the NAPO-WDC Corporate Partner page.

Free

Additional Services Available

I would like my company logo to be an active link on the NAPO-WDC Corporate Partner page.

$50

I am adding Corporate Partner Associate(s) to my membership ($75 per additional member).

# of Associates being designated:

$75 each

Corporate Partner Associate
Companies applying for a Corporate Partner Membership are permitted one primary member as the liaison to NAPO-WDC. Additional employees of the company may join as Corporate Partner Associates for $75 per Corporate Partner Associate per year. Register Corporate Partner Associate(s) below:
Associate #1 Name:
Associate #1 Title:
Associate #2 Name:
Associate #2 Title:
Associate #3 Name:
Associate #3 Title:

Yes, I have received and read a copy of the NAPO Code of Ethics.

Additional Membership Information
All marketing activities must be pre-approved by the Corporate Partner Committee. Call Kim Oser to discuss ideas at 240-350-9091. NAPO-WDC’s membership year runs from October 1st to September 30th. Membership dues are not pro-rated for mid-year applicants. Membership dues are non-refundable. Any requests for exception to this policy must be submitted for consideration in writing and will be decided on a case-by-case basis. Submission of this form consitutes an electronic signature. No refunds will be given once your application has been electronically processed. Please click the "Register Now" button only once.
Members Only Area Login Information
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Password:
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