gltsa - Application Form

Application Form

Please complete all fields that apply to your firm.
[Note that fields with yellow labels are required]

Contact Person #1
Contact #1 Email Addr
Contact Person #2
Contact #2 Email Addr
To list more contacts, provide the information in "Additional Information", below.
Company Name
Mailing Address
City
State
ZIP
To list more than one address, provide the information in "Additional Information", below.
Telephone
Fax
Website Address
Company Email Address

Services and Specialties Check ALL that apply. (Will be used for searchable listing for web site.)	Telephone Answering Service Order-Taking Service (Inbound Telemarketing) Outbound Telemarketing Voice Mail Pagers Paging Service Alpha (Text Messaging) Dispatch Wireless Cellular Phones Mail Receiving Mail Forwarding Internet Dialup Service Alarm Monitoring Other:

Memberships & Affiliations	ATSI Better Business Bureau Chamber of Commerce User Group (which one?) Other (Specify)

In business since (year)

Equipment/Vendors Used Please list major vendors as a resource to fellow members

Additional Information

Membership Level For more information on Membership Levels,click here	Level 1 -- $170 Level 2 -- $290 Level 3 -- $410 Auxiliary Member -- $100

Payment will be submitted by Indicate date by which your payment should be received by GLTSA

Membership Confirmation	By submitting this Application and payment of annual dues, I confirm that I will support the purpose of GLTSA and subscribe to the ByLaws and Code of Ethics of the Association. I have not yet reviewed the ByLaws and Code of Ethics, but agree to be bound by them.
Person completing Application

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May 21-22, 2013 - Ft. Wayne IN - Hyatt Place Hotel $99 Tuesday 9a-4p, Wednesday 9a-Noon Inspiring Motivated Employees to Perform Presented by Jan Lee Download: Program Overview & Registration Jan Lee Biography Easy to get to and worth the drive
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