Institute for Supply Management

COOPERATIVE UTILITIES AFFILIATE (CODE 12/537)

ONLINE MEMBERSHIP APPLICATION

Note: No payment is required at this time. We will automatically invoice you later for annual dues of $135 ($35 Dual Membership)

What type of membership are you requesting?    Regular Member Dual Member

If dual, please list which affiliate you are already a member of:  

Please tell us how to get in touch with you:

Name:                     

Title:                        

Company:               

Street Address:     

City, State & Zip:   

Business Phone:    (include area code & extension)

Fax:                                

Email:                     

We'd like to know a little more about you:

Total number of years in current position:

Are you currently certified as a: C.P.M.  ~  A.P.P.  ~  Other  ~  Not Currently Certified

Please list year certified if applicable:

Are you involved in sales?:     If yes, please explain:     

Please select which ISM-CU Committee you would like to assist with:

Please enter any comments in the space provided below:

Please Note:  By Clicking the "Join Us!" button below, you agree to abide by all ISM Bylaws, Principles and Standards of Purchasing Practice as well as their Statement of Anti-trust Policy and the Bylaws of our affiliate. Our simple membership directory (names, addresses, phone, etc...) is publicly available via our web site. For directory exclusion, additional questions or comments, please complete the above field or directly email Marketing Chair Tony Gully at tgully@grenergy.com. As previously stated, you will be automatically invoiced for annual dues of $135 ($35 Dual Membership). Upon submission of this form, please print the generated confirmation page for your records. An affiliate volunteer will contact you shortly thereafter.