2015 INSTITUTIONAL MEMBER APPLICATION

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "2015 INSTITUTIONAL MEMBER APPLICATION"

Transcription

1 2015 INSTITUTIONAL MEMBER APPLICATION ASET The Neurodiagnostic Society 402 E. Bannister Road, Suite A Kansas City, MO Tel: * Fax: * To apply for membership, return completed application with payment by mail or by fax. ASET membership is from January through December. First-year dues are pro-rated based on join date. For Institutions joining October through December, membership runs through December of the following year. Section I: Membership Category/ Chapter Affiliation INSTITUTIONAL MEMBERSHIP - Health care delivery or educational institutions which employ or educate neurodiagnostic technologists. Dues include membership for one primary billing contact, and up to four additional employees. EACH ADD-ON EMPLOYEE - Institutions may enroll more than the five employees included in the base Institutional member dues at the per employee add-on rate. Please check ASET membership type: INSTITUTIONAL MEMBERSHIP Jan March $435 US $485 Non-US April June $326 US $364 Non-US July Sept $218 US $243 Non-US Oct Dec $435 US $485 Non-US EACH ADD-ON EMPLOYEE $75 US $85 Non-US $56 US $64 Non-US $37 US $43 Non-US $75 US $85 Non-US INSTITUTIONAL/CORPORATE CHAPTER MEMBERSHIP Chapters are local, state or regional neurodiagnostic organizations that have been officially chartered by ASET. They provide continuing education and timely communication, allowing your institution to stay abreast of developments in the neurodiagnostic profession in your locality. Joining one or more chapters is optional. Institutional/Corporate Chapter membership applies only to the Institution and may not carry with it the same rights and privileges as individual chapter membership. Visit the chapter websites for information on member benefits and privileges. If your institutional employees would like to affiliate directly with a chapter, please instruct them to file an individual member application directly with the chapter. Contact information and links to each chapter s websites are posted at (click on Chapters under the Membership tab drop-down menu). One hundred percent of chapter dues collected by ASET are rebated to the respective chapters.for your institution to also join a chapter(s), please select from the following and include the amount of chapter dues in your total payment: Please check Chapter membership type: Jan March April June July Sept Oct Dec *ISETT (Indiana) $30 $23 $15 $30 * ISETT Institutional dues per employee member Section II: Applicant Information Organization Name: Business Mailing Address: City: State/Province: Business Phone: [ ] Zip/Postal Code: Country: Business Fax: [ ] Number of Neurodiagnostic Technologists Employed by Institution: Reference Code (if applicable): How did you hear about ASET? Hospital Administration Co-worker ABRET Tradeshow Advertisement Direct Mail Internet Broadcast Social Media (Specify) Other (Specify) Section III: Primary Billing Contact Information Please identify the Institutional employee to serve as the primary billing contact. This individual will receive the Institutional member subscription to The Neurodiagnostic Journal and the ASET newsletter, and will receive an individually-assigned ASET ID number, member log-in, and password for accessing the Members Only section of the ASET website and to qualify for member rates on ASET training courses, products and services. Primary billing contacts have voting privileges and may serve on ASET committees, but are not eligible to serve as a trustee or officer of the Society (unless they upgrade their membership to the Active member class). Last Name: First Name: * Required field. Representative s log-in and password to access the Members Only pages of the ASET website will be automatically assigned and ed to him/her upon approval of application. Representative may change his/her

2 2 year Associates Degree BA BS MA MS MEd PhD Other Membership information is included in ASET s searchable on-line membership directory. However, we recognize the importance of employee privacy and provide employees with options relating to their listing. If no option is selected, membership information will be included in the searchable member directory. Information as noted above can be included in the on-line member directory. Information is not to be included in the on-line member directory. Section IV: Employee Member Information In addition to the Primary Billing Contact, up to four more employees may be enrolled under an Institutional membership at no additional cost. Each employee enrolled will receive an individual subscription to The Neurodiagnostic Journal and the ASET newsletter, and will receive an individuallyassigned ASET ID number, member log-in, and password for accessing the Members Only section of the ASET website and to qualify for member rates on ASET training courses, products and services. Institutional employee members have voting privileges and may serve on ASET committees, but are not eligible to serve as a trustee or officer of the Society (unless they upgrade their membership to the Active member class). In the event of employment changes and/or new hires, an Institution may add employees to its Institutional membership, transfer an employee s membership to another employee, or inactivate an employee s membership, at any time throughout the year simply by calling the ASET Executive Office EMPLOYEE 1: 2 year Associates Degree BA BS MA MS MEd PhD Other

3 EMPLOYEE 2: 2 year Associates Degree BA BS MA MS MEd PhD Other EMPLOYEE 3: R. EEG T. R. EP T. RPSGT CNIM R.NCS.T. CLTM Other 2 year Associates Degree BA BS MA MS MEd PhD Other

4 EMPLOYEE 4: 2 year Associates Degree BA BS MA MS MEd PhD Other Section V: Add-on Employee Member Information Institutional members may enroll more than the five employees covered by the base Institutional member dues at the add-on employee rate listed herein. There is no limit to the number of employees that an Institutional member may enroll. Each additional employee enrolled will receive an individual subscription to The Neurodiagnostic Journal and the ASET newsletter, and will receive an individually-assigned ASET ID number, member login, and password for accessing the Members Only section of the ASET website and to qualify for member rates on ASET training courses, products and services. For each add-on employee, please complete the following information. Please duplicate this section and attach to this application if more than one addon employee is being enrolled. Add-on Employee 1:

5 2 year Associates Degree BA BS MA MS MEd PhD Other Section VI: Communication Consent Federal regulations by the FCC require ASET to have permission before we can communicate with Institutional member employees via fax or about important products, programs or services. I hereby give ASET this day of, 20 written permission to send notices, advertisements, announcements, brochures, invoices and other information from ASET via facsimile and /or at the numbers and address shown herein. This permission will have no date of expiration.* Signature Date On occasion, ASET may rent member mailing addresses and addresses to its business associates and third-parties for marketing purposes. If you would like to be included in these communications, please check each item that applies:* Business associates/third-party mail Business associates/third-party * Institutional employee members may opt-out from receiving communications from ASET and/or its business associates in the future by logging on to the Members Only section of the ASET website and changing their communication preferences. Section VII: Payment Information Check or Money Order payable to ASET The Neurodiagnostic Society [payment must be in US dollars drawn on a US bank] American Express Discover MasterCard Visa Name on Card Account No --- Expiration Date / Billing Zip Code CID Month Year Cardholder Signature $ ASET General Operations Fund [optional] $ TOTAL ENCLOSED** made payable to ASET The Neurodiagnostic Society [Federal Tax ID# ] In addition to dues, enclosed is $ as a donation to the ASET Foundation General Fund (Federal Tax ID # ) Please include do not include our Institution s name in the donation acknowledgment. Make foundation donations payable to the ASET Foundation. Gifts made to the ASET Foundation are deductible as a charitable contribution in the year in which they are given. (Federal Tax ID# ) **ASET estimates that of the non-deductible portion of the 2015 Institutional member base dues, the portion that is allocable to lobbying activities, is $ Annual subscriptions to The Neurodiagnostic Journal and ASET News are included with your membership and may not be deducted from dues. Dues portions allotted for publications are $10 for the newsletter and $75 for the journal. ASET s FEIN is A member may resign or cancel their membership at any time by submitting their resignation in writing to Membership dues are non-refundable.

MEMBER BENEFITS MEMBERSHIP WITH FLORIDA HOSPICE AND PALLIATIVE CARE ASSOCIATION. Patron Associate

MEMBER BENEFITS MEMBERSHIP WITH FLORIDA HOSPICE AND PALLIATIVE CARE ASSOCIATION. Patron Associate MEMBERSHIP WITH FLORIDA HOSPICE AND PALLIATIVE CARE ASSOCIATION So what do you get as a member of Florida Hospices and Palliative Care? See the chart below for a look at what a FHPC membership can offer

More information

Membership Application

Membership Application Please type or print clearly Application date Organization name Address City State Zip+4 Primary contact name Telephone Fax Primary contact email Company website address to appear in web listing Business

More information

1. First MI Last Preferred Email. 2. First MI Last Preferred Email. 3. First MI Last Preferred Email. 4. First MI Last Preferred Email

1. First MI Last Preferred Email. 2. First MI Last Preferred Email. 3. First MI Last Preferred Email. 4. First MI Last Preferred Email Group Membership Application Hospital/Institution Name Address City State/Province Zip/Postal Code Contact Name Title Phone Members All new members and existing members who are renewing* their membership

More information

AALNC - GREATER INDIANAPOLIS LOCAL CHAPTER MEMBERSHIP FORM

AALNC - GREATER INDIANAPOLIS LOCAL CHAPTER MEMBERSHIP FORM Greater Indianapolis Chapter of AALNC American Association of Legal Nurse Consultants PO Box 1702 www.indyaalnc.org AALNC - GREATER INDIANAPOLIS LOCAL CHAPTER By-laws of the National AALNC require membership

More information

South Metro Denver REALTOR Association Membership Application

South Metro Denver REALTOR Association Membership Application South Metro Denver REALTOR Association Membership Application Affiliate Affiliate Members are individuals representing a firm or acting individually in a business related to the real estate profession

More information

An independent voice, advocate and resource for the community of massage schools and educators

An independent voice, advocate and resource for the community of massage schools and educators You re invited to become a member of the national organization for massage schools, teachers and continuing education providers An independent voice, advocate and resource for the community of massage

More information

Appendix B: Certified Technology Specialist Design (CTS-D) - Exam Application

Appendix B: Certified Technology Specialist Design (CTS-D) - Exam Application Appendix B: Certified Technology Specialist Design (CTS-D) - Exam Application Section I: Summary of Eligibility Requirements To be eligible to take the CTS-D exam, a candidate must: Hold current certification

More information

New Member Application Checklist: Thank you for your interest in joining the Chicago Association of REALTORS (C.A.R.).

New Member Application Checklist: Thank you for your interest in joining the Chicago Association of REALTORS (C.A.R.). Chicago Association of REALTORS 200 South Michigan Avenue #400, Chicago, IL 60604 Monday Friday, from 8:30 a.m. - 5 p.m. 6017 W. 26th St. Cicero, IL 60804 Tuesdays and Thursdays, from 9 a.m. to Noon and

More information

Government Finance Officers Association Training Seminars Registration Form January 2016 April 2016

Government Finance Officers Association Training Seminars Registration Form January 2016 April 2016 Government Finance Officers Association Training Seminars Registration Form January 2016 April 2016 GFOA retains the right to close classes that are full or cancel classes due to low enrollment Please

More information

COPM Vendor CEU Pre-Approval Rev. 6/2012

COPM Vendor CEU Pre-Approval Rev. 6/2012 The Association of Otolaryngology Administrators fosters professional development, networking and support to administrative leaders in Otolaryngology. COPM Vendor CEU Pre-Approval Rev. 6/2012 COPM Vision

More information

Resident Experience. ResidentPay - Resident Experience 1

Resident Experience. ResidentPay - Resident Experience 1 Resident Experience To pay rent online, you need to first enroll in ResidentPortal. You can navigate to the ResidentPortal from the property s website. The link to ResidentPortal is most commonly displayed

More information

Online Bill Pay User Manual

Online Bill Pay User Manual \ Online Bill Pay User Manual Updated: November 14, 2014 Page 1 Table of Contents I. Welcome to Online Bill Pay... 3 II. New User Registration... 4 III. Login for Registered Users... 7 IV. Home Page Functionality...

More information

Application for REALTOR Membership (Brokers, agents and licensed/certified appraisers) Rev 9-11

Application for REALTOR Membership (Brokers, agents and licensed/certified appraisers) Rev 9-11 Application for REALTOR Membership (Brokers, agents and licensed/certified appraisers) Rev 9-11 For Office Use Only Date Received Check # Amount $ Name on Check Applicants for primary, secondary, or Designated

More information

FULL-TIME ESL AND TEST PREPARATION PROGRAMS NEW STUDENT APPLICATION

FULL-TIME ESL AND TEST PREPARATION PROGRAMS NEW STUDENT APPLICATION Continuing and Professional Studies One Bernard Baruch Way Box B1-116 New York, NY 10010-5585 Tel: 646-312- 5000 Fax: 646-312- 5101 CAPS@baruch.cuny.edu FULL-TIME ESL AND TEST PREPARATION PROGRAMS NEW

More information

Join MBA now to receive special membership benefits. Membership dues start at $1,300 (less than $70 a month).

Join MBA now to receive special membership benefits. Membership dues start at $1,300 (less than $70 a month). The Mortgage Bankers Association (MBA) is your specialist for the new mortgage world. We have the tools your business needs not just to survive, but thrive. Join MBA now to receive special membership benefits.

More information

The Voice for Real Estate in Chicago Phone: (312) Fax: (312)

The Voice for Real Estate in Chicago Phone: (312) Fax: (312) Chicago Association of REALTORS 200 South Michigan Avenue #400, Chicago, IL 60604 6600 West Irving Park, Chicago, IL 60634 7600 South Pulaski, Chicago, IL 60652 The Voice for Real Estate in Chicago Phone:

More information

The Cruise Industry s Vacation Medical Plan

The Cruise Industry s Vacation Medical Plan SHIP Shoreside Health Insurance Plan The Cruise Industry s Vacation Medical Plan Distributed by: INSURANCE BROKERS Signing off? Take the Shoreside Health Insurance Plan (SHIP) with you! SHIP is designed

More information

SMALL BUSINESS HEALTH OPTIONS PROGRAM. Marketplace EMPLOYER ENROLLMENT USER GUIDE

SMALL BUSINESS HEALTH OPTIONS PROGRAM. Marketplace EMPLOYER ENROLLMENT USER GUIDE SMALL BUSINESS HEALTH OPTIONS PROGRAM Marketplace EMPLOYER ENROLLMENT USER GUIDE Table of Contents 1. SHOP Marketplace Employer Enrollment Application...3 Create a HealthCare.gov account...4 Create a profile...6

More information

ASIFMA NON-BANK MEMBERSHIP APPLICATION FOR 2015-2016

ASIFMA NON-BANK MEMBERSHIP APPLICATION FOR 2015-2016 ASIFMA NON-BANK MEMBERSHIP APPLICATION FOR 2015-2016 Firm Name* Address City State/Province Zip/Postal Code Country Web Site Address NOMINATED REPRESENTATIVE** Name Title Department and Floor Phone Fax

More information

Please use the following index links to quickly access the information you are looking for:

Please use the following index links to quickly access the information you are looking for: Please use the following index links to quickly access the information you are looking for: Create a new My PHLY account Registration for Agents Auto ID Web Edit Profile Logout instructions Online Bill

More information

b. New *Association Transfer * Secondary Membership

b. New *Association Transfer * Secondary Membership The term REALTOR is a professional trade association designation and symbolizes the distinction between the average real estate licensee and a member of organized real estate. PROCEDURE: Complete and sign

More information

Submit Completed Application Packet and Documents To: Partner Enrollment. By Mail: By Fax: (407) 567-7654 By Email:

Submit Completed Application Packet and Documents To: Partner Enrollment. By Mail: By Fax: (407) 567-7654 By Email: Thank you for your interest in becoming a Certified Stone and Tile PRO Partner. Following is the application packet which includes: 1. Partner Application 2. Commitment to Professional Integrity 3. Partner

More information

Appendix B: Certified Technology Specialist- General (CTS) - Exam Application

Appendix B: Certified Technology Specialist- General (CTS) - Exam Application Appendix B: Certified Technology Specialist- General (CTS) - Exam Application Section I: Summary of Eligibility Requirements To be eligible to take the general CTS exam, a candidate must: Agree to the

More information

2015 LMG Education Center Training Class Schedule

2015 LMG Education Center Training Class Schedule 2015 LMG Education Center Training Class Schedule Class Pricing Medical Assistant (MA) Training Class Includes in-house certification, CPR certification, and national certification testing after 1 year

More information

Dear Principia Billing Services Customers,

Dear Principia Billing Services Customers, Dear Principia Billing Services Customers, The Principia Billing Services Office is pleased to announce our new online bill called PrinBill. It can be accessed at www.prinbill.com. PrinBill is powered

More information

Primary REALTOR or REALTOR Associate Membership Application Instructions

Primary REALTOR or REALTOR Associate Membership Application Instructions Primary REALTOR or REALTOR Associate Membership Application Instructions A basic prerequisite for membership is that you be licensed with a firm whose broker is a REALTOR member and/or MLS Participant

More information

Standard Mutual Insurance Company

Standard Mutual Insurance Company Standard Mutual Insurance Company Documentation for Policyholder Access - Pay Online Policyholder Access - Pay Online July 26, 2013 Policyholder Access Page 0 Table of Contents Pay Online Policyholder

More information

Job Aid: Password Reset

Job Aid: Password Reset Job Aid: Password Reset Purpose The purpose of this Job Aid is to guide users through the step-by-step process of enabling security questions and resetting their passwords. In this Job Aid, you will learn

More information

DC DMV WEBSITE ACCESS REQUEST AND APPROVAL

DC DMV WEBSITE ACCESS REQUEST AND APPROVAL DC DMV WEBSITE ACCESS REQUEST AND APPROVAL Insurance companies who choose to report via District Of Columbia Department of Motor Vehicles (DC DMV) website must request a Company ID, User ID and Password.

More information

The ZIS Parents Portal is a central resource for the parents and guardians, bringing information from a variety of sources into one place.

The ZIS Parents Portal is a central resource for the parents and guardians, bringing information from a variety of sources into one place. Parents Portal The ZIS Parents Portal is a central resource for the parents and guardians, bringing information from a variety of sources into one place. On the home page there are some of the most frequently

More information

MYOB Professional Partner Public Accountant

MYOB Professional Partner Public Accountant MYOB Professional Partner Public Accountant Partner Benefits FACTSHEET As an accountant in public practice, you know how important it is for your practice to keep pace with the ever-changing technology

More information

Company Name: MC# Address: (city/state/zip) Owner Name: Contact Name: Title: Phone: Fax: Alternative Phone Numbers: Web Address: Email address:

Company Name: MC# Address: (city/state/zip) Owner Name: Contact Name: Title: Phone: Fax: Alternative Phone Numbers: Web Address: Email address: Software Contract Company Name: MC# Address: (city/state/zip) Owner Name: Contact Name: Title: Phone: Fax: Alternative Phone Numbers: Web Address: Email address: Billing Contact Street: Billing Contact

More information

Colorado Association of Certified Veterinary Technicians Certification / Membership Renewal Application July 1, 2014 June 30, 2016

Colorado Association of Certified Veterinary Technicians Certification / Membership Renewal Application July 1, 2014 June 30, 2016 Colorado Association of Certified Veterinary Technicians Certification / Membership Renewal Application July 1, 2014 June 30, 2016 CACVT is the governing body and professional association for Certified

More information

Stay. connected protected. with the AB Service Agreement. AdvancedBionics.com

Stay. connected protected. with the AB Service Agreement. AdvancedBionics.com Stay connected protected with the AB Service Agreement AdvancedBionics.com Stay connected protected with the AB Service Agreement As your partner in hearing, Advanced Bionics wants to help you to avoid

More information

INVITES YOU TO APPLY FOR MEMBERSHIP IN THE ASSOCIATION REPRESENTING RICE MILLERS AND ASSOCIATES

INVITES YOU TO APPLY FOR MEMBERSHIP IN THE ASSOCIATION REPRESENTING RICE MILLERS AND ASSOCIATES Charter Member: USA Rice INVITES YOU TO APPLY FOR MEMBERSHIP IN THE ASSOCIATION REPRESENTING RICE MILLERS AND ASSOCIATES Contacts Robert Trahan, Chairman USA Rice Millers Association Phone (337) 783-3825

More information

BIGGER. Become Part of Something. Get connected with APCO, first in education, information and advocacy. PUBLIC SAFETY PRACTITIONER

BIGGER. Become Part of Something. Get connected with APCO, first in education, information and advocacy. PUBLIC SAFETY PRACTITIONER PUBLIC SAFETY PRACTITIONER Become Part of Something MEMBERSHIP INFORMATION INSIDE BIGGER Get connected with APCO, first in education, information and advocacy. JOIN & BELONG APCO MEMBERSHIP keeps you connected

More information

Credit Cards in BillQuick

Credit Cards in BillQuick Time Billing and Project Management Software Built With Your Industry Knowledge Credit Cards in BillQuick User Guide for BillQuick Users BQE Software, Inc. 2601 Airport Drive, Suite 380 Torrance CA 90505

More information

2015 MEMBERSHIP APPLICATION

2015 MEMBERSHIP APPLICATION 2015 MEMBERSHIP APPLICATION Membership in East Bay CREW is available to anyone who is employed full-time in a professional position; the primary responsibilities are in a qualified field of commercial

More information

300 S. Mahoney Drive, Ste C-14, P.O. Box 2485 Telluride, CO 81435. Phone: (970) 728-5172 Fax: (970) 728-5270

300 S. Mahoney Drive, Ste C-14, P.O. Box 2485 Telluride, CO 81435. Phone: (970) 728-5172 Fax: (970) 728-5270 300 S. Mahoney Drive, Ste C-14, P.O. Box 2485 Telluride, CO 81435 Phone: (970) 728-5172 Fax: (970) 728-5270 Dear Potential Telluride Association of REALTORS Member, Attached please find all of the necessary

More information

MAKING PAYMENTS ONLINE. ELECTRONIC CHECKING (ACH) PAYMENTS PINLESS ATM DEBIT CARD PAYMENTS CREDIT CARD(only for Deposit Payments)

MAKING PAYMENTS ONLINE. ELECTRONIC CHECKING (ACH) PAYMENTS PINLESS ATM DEBIT CARD PAYMENTS CREDIT CARD(only for Deposit Payments) MAKING PAYMENTS ONLINE ELECTRONIC CHECKING (ACH) PAYMENTS PINLESS ATM DEBIT CARD PAYMENTS CREDIT CARD(only for Deposit Payments) On the Hofstra home page (www.hofstra.edu) click (myhofstra) to log onto

More information

Banner Self-Service User Support. Set Up an Automatic Payment Plan

Banner Self-Service User Support. Set Up an Automatic Payment Plan Set Up an Automatic Payment Plan Banner Self-Service You have three options when paying your fees online in Banner Self-Service. You can use Visa, MasterCard or Discover. Set up an automatic payment plan

More information

Last Name: First: M.I.: DOB: Business Country: Business Phone #: Business Cellular #:

Last Name: First: M.I.: DOB: Business Country: Business Phone #: Business Cellular #: APPLICANT INFORMATION Last Name: First: M.I.: DOB: Street City: State: Zip: Country: Phone #: Cellular #: Email: EMPLOYMENT Present Employer: Date Started: Type of Business: Current Position: Business

More information

HERNANDO COUNTY INFORMATION SERVICE (HCIS) 7321 Sunshine Grove Rd. Brooksville, FL FAX:

HERNANDO COUNTY INFORMATION SERVICE (HCIS) 7321 Sunshine Grove Rd. Brooksville, FL FAX: HERNANDO COUNTY INFORMATION SERVICE (HCIS) 7321 Sunshine Grove Rd. Brooksville, FL 34613 352-799-1971 FAX: 352-799-4350 APPLICATION FOR PARTICIAPTION IN A BOARD- OWNED MLS I, Qualifying Broker of Record

More information

Online Account Management Broker s User Guide

Online Account Management Broker s User Guide Online Account Management Broker s User Guide TABLE OF CONTENTS BROKER SINGLE SIGN-ON ACTIVATION ------------------------------------------------------------------- 3 BROKER SINGLE SIGN-ON REQUEST FORM

More information

VOUCHER ORDER FORM VOUCHER RECEIPT ACKNOWLEDGEMENT

VOUCHER ORDER FORM VOUCHER RECEIPT ACKNOWLEDGEMENT VOUCHER ORDER FORM Please complete the top portion of this form to place your voucher order and return to Stephanie Maes via mail, e-mail, or fax with a copy of the organization W-9 and 501(c)3 determination

More information

Graduate and Professional Programs SUPPLEMENT for Doctor of Nursing Practice (BSN to DNP)

Graduate and Professional Programs SUPPLEMENT for Doctor of Nursing Practice (BSN to DNP) Graduate and Professional Programs SUPPLEMENT for Doctor of Nursing Practice (BSN to DNP) Applying for Admission Application Steps for Doctor of Nursing Practice (BSN to DNP) Applicants: 1. Submit the

More information

CERTIFIED DESIGN FIRM ADMINISTRATOR. APPLICATION FORM for the CDFA Examination

CERTIFIED DESIGN FIRM ADMINISTRATOR. APPLICATION FORM for the CDFA Examination CERTIFIED DESIGN FIRM ADMINISTRATOR APPLICATION FORM for the CDFA Examination Society for Design Administration CDFA Certification Program 8190-A Beechmont Avenue, #276 Cincinnati, OH 45255-6117 Telephone:

More information

CHARITABLE SOLICITATIONS PROGRAM. Charitable Organization Renewal Application License Fee: $25. Late Fee: $50. (if filed after November 30th)

CHARITABLE SOLICITATIONS PROGRAM. Charitable Organization Renewal Application License Fee: $25. Late Fee: $50. (if filed after November 30th) STATE OF MAINE DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION OFFICE OF LICENSING AND REGISTRATION CHARITABLE SOLICITATIONS APPLICATION RENEWAL APPLICANT INFORMATION (please print) FULL LEGAL NAME

More information

STUDENT SUBSCRIBER. Application for admission. psychology.org.au. April 2015

STUDENT SUBSCRIBER. Application for admission. psychology.org.au. April 2015 STUDENT SUBSCRIBER Application for admission April 2015 psychology.org.au STUDENT SUBSCRIBER Belonging to the Australian Psychological Society (APS) means you are part of an active, progressive organsiation

More information

Business Partner Application Form

Business Partner Application Form Business Partner Application Form Thank you for your interest in becoming a Business Partner of The Lakelands Association of REALTORS ( LAR ). The terms and benefits of becoming a Business Partner are

More information

HEALTH SAVINGS ACCOUNT (HSA) APPLICATION

HEALTH SAVINGS ACCOUNT (HSA) APPLICATION HEALTH SAVINGS ACCOUNT (HSA) APPLICATION IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT To help the government fight the funding of terrorism and money laundering activities, Federal

More information

Check Acceptance Policy

Check Acceptance Policy Check Acceptance Policy COPART, INC. Member A/R 4610 Westamerica Drive Fairfield, CA 94534 Why Cashier s Checks or Money Orders are required Members are required to pay by Cashier s Check or Money Order

More information

Now That You Are Accepted (From Acceptance to Matriculation)

Now That You Are Accepted (From Acceptance to Matriculation) Now That You Are Accepted (From Acceptance to Matriculation) a new state of mind Office of Admissions, Recruitment and Scholarships Post Office Box 7127 Orangeburg, South Carolina Tel: 803-536-7186 Fax:

More information

LOMA May 2016 Enrollment Instructions

LOMA May 2016 Enrollment Instructions LOMA May 2016 Enrollment Instructions These are your instructions for enrolling students for May 2016 paper examinations. You may photocopy these instructions and forward them to your company's branch

More information

How to create an email template

How to create an email template How to create an email template Templates are created the same way as you would for any other content page for an html or text email. By checking the box next to the Name this Content field on the Create

More information

Online Donation Guide

Online Donation Guide Online donations to Green & Healthy Homes Initiative Detroit-Wayne County (GHHI Detroit-Wayne County) are processed through Wayne State University (WSU) as fiduciary. WSU does not charge a fee per transaction,

More information

365 Eddy Street, Suite 1, Providence, RI 02903 Phone: (401) 274-8386 Fax: (888) 909-6406 Email: info@ricabor.org Web: www.ricabor.

365 Eddy Street, Suite 1, Providence, RI 02903 Phone: (401) 274-8386 Fax: (888) 909-6406 Email: info@ricabor.org Web: www.ricabor. 365 Eddy Street, Suite 1, Providence, RI 02903 Phone: (401) 274-8386 Fax: (888) 909-6406 Email: info@ricabor.org Web: www.ricabor.org Applying as a Principal Broker or Principal Appraiser of an Office

More information

Eastern Bank TreasuryConnect Security Center User Manual

Eastern Bank TreasuryConnect Security Center User Manual Eastern Bank TreasuryConnect Security Center User Manual This user manual provides instructions for using the Password Reset feature and accessing services found within the Security Center Group. The services

More information

ONLINE PAYMENT SYSTEM (ebilling) HELP GUIDE

ONLINE PAYMENT SYSTEM (ebilling) HELP GUIDE ONLINE PAYMENT SYSTEM (ebilling) HELP GUIDE A CONVENIENT WAY TO PAY YOUR MONTHLY PREMIUM Get Started with ebilling... 1 Set Your ebilling Preferences... 1 Using the Payment Center...2 Make a Payment...2

More information

2015 Exhibitor Information

2015 Exhibitor Information 2015 Exhibitor Information You are invited to participate as a professional exhibitor at our 15 th Annual National Conference at Rio All-Suite Hotel & Casino in Las Vegas, Nevada. We expect to have approximately

More information

2011 CSHP Catch the Wave CONFERENCE INFORMATION FOR OUR EXHIBIBITORS AND SPONSORS

2011 CSHP Catch the Wave CONFERENCE INFORMATION FOR OUR EXHIBIBITORS AND SPONSORS CONFERENCE INFORMATION FOR OUR EXHIBIBITORS AND SPONSORS If you ve questions about registration and/or payment, please contact the CSHP office at 888/506-3784 or office@cshponline.org DATES and NEW LOCATION

More information

Advanced SPIRIT Association

Advanced SPIRIT Association Advanced SPIRIT Association Registration Packet Ladybug Classic April 5, 2014 Whittemore Center Durham, NH REGISTRATION PACKET CHECKLIST STEP 1: Program Information Please complete all contact information

More information

Lexington Chinese School Online Class Registration Step-by-step Instructions

Lexington Chinese School Online Class Registration Step-by-step Instructions Lexington Chinese School Online Class Registration Step-by-step Instructions Introduction Account Setup Add Your Family Profile Register Your Children for Classes I. Introduction The instructions guide

More information

Get up to 30% off! GROUP REGISTRATION. October 29 31, 2013 Expo: October 30 & 31 Santa Clara Convention Center Santa Clara, CA

Get up to 30% off! GROUP REGISTRATION. October 29 31, 2013 Expo: October 30 & 31 Santa Clara Convention Center Santa Clara, CA step 1 ARM TECHCON GROUP OPTIONS ARM TechCon group registration discount applies to 2 or more All Access Conference Passes. The Expo-Only Pass is free and therefore, excluded from the group discount. Note:

More information

Certified Housekeeping Manager

Certified Housekeeping Manager CHM APPLICATION FORM Certified Housekeeping Manager Promo Code: SECTION 1 You may apply for certification under one of three different plans. Check the plan that applies to you and be sure to read each

More information

INSTITUTE OF TRANSPORTATION ENGINEERS GREATER DALLAS SECTION BYLAWS

INSTITUTE OF TRANSPORTATION ENGINEERS GREATER DALLAS SECTION BYLAWS INSTITUTE OF TRANSPORTATION ENGINEERS GREATER DALLAS SECTION BYLAWS ARTICLE I - NAME AND PURPOSE Section 1.1 - The name of this organization shall be the Greater Dallas Section of the Texas District of

More information

2016 Registration Instructions and Checklist

2016 Registration Instructions and Checklist INSTRUCTIONS 51 Brattle Street, Cambridge, Massachusetts 02138-3722 summer.harvard.edu 2016 Registration Instructions and Checklist For faster service, register online with a credit card at summer.harvard.edu/login

More information

No program Annual Aggregate Limit. Full prior acts coverage for qualified agents. Competitive Premium Rates:

No program Annual Aggregate Limit. Full prior acts coverage for qualified agents. Competitive Premium Rates: Is E&O Insurance Necessary? You Decide!!! Program Highlights Basic liability limit is $1,000,000 per claim and annual aggregate per agent with optional $2,000,000 limit available; No program Annual Aggregate

More information

Senior Professional in Supply Management (SPSM) Application for Original Certification

Senior Professional in Supply Management (SPSM) Application for Original Certification Senior Professional in Supply Management (SPSM) Application for Original Certification This application is to be completed after satisfying the original certification requirements. To register for the

More information

Iowa Association of Legal Assistants.Paralegals (IALA.P)

Iowa Association of Legal Assistants.Paralegals (IALA.P) Iowa Association of Legal Assistants.Paralegals (IALA.P) Have you ever wondered what other paralegals are doing for their profession? Have you ever wanted to get involved in promoting your career? If so,

More information

Application for Initial Students, Reinstatement Students, and Visa Status Change Students

Application for Initial Students, Reinstatement Students, and Visa Status Change Students Application for Initial Students, Reinstatement Students, and Visa Status Change Students 1. Please complete and sign this application form. Your application cannot be processed without the following :

More information

Sam Houston State University Procurement Card Program

Sam Houston State University Procurement Card Program Sam Houston State University Procurement Card Program Citi Card GCMS On-Line Cardholder Reference Guide COMMERCIAL CARD ADMINISTRATOR: KATHY ROBERTS OFFICE PHONE: 936-294-1991 OFFICE FAX: 936-294-1997

More information

Fresno Association of REALTORS 6720 N. West Fresno, CA 93711 Phone (559)490-6400 Fax (559)490-6464

Fresno Association of REALTORS 6720 N. West Fresno, CA 93711 Phone (559)490-6400 Fax (559)490-6464 Joined Date Fresno Association of REALTORS 6720 N. West Fresno, CA 93711 Phone (559)490-6400 Fax (559)490-6464 Member # Office # For Office Use Only Application for REALTOR and/or Multiple Listing Service

More information

Online Statements. About this guide. Important information

Online Statements. About this guide. Important information Online Statements About this guide This guide shows you how to: View online statements, including CommBiz Activity Statements (Billing summaries) and online statements for Transaction Accounts, Credit

More information

GYMNASTICS ONLINE USER GUIDE - Technical Members. Last Updated: 08/10/2014

GYMNASTICS ONLINE USER GUIDE - Technical Members. Last Updated: 08/10/2014 GYMNASTICS ONLINE USER GUIDE - Technical Members Last Updated: 08/10/2014 TABLE OF CONTENTS 1. Login to Gymnastics Online website... 3 2. Check and Update your Personal Contact Details... 5 3. View your

More information

Join the Independent Insurance Agents and Brokers of Arizona as an Associate Member and start receiving your benefits now!

Join the Independent Insurance Agents and Brokers of Arizona as an Associate Member and start receiving your benefits now! Join the Independent Insurance Agents and Brokers of Arizona as an Associate Member and start receiving your benefits now! Up-to-date information on Legislation, Regulation and Industry Trends, that will

More information

BGL Client Centre Set up Instructions

BGL Client Centre Set up Instructions BGL Client Centre Set up Instructions What is the BGL Client Centre? The BGL Client Centre provides you with a direct connection to BGL. At the Client Centre you can: View your client details Log a support

More information

ProCessInG life. life membership Cards

ProCessInG life. life membership Cards ProCessInG life membership applications Anyone eligible for VFW membership also has the option of becoming a life member. By opting for this membership, individuals save a significant amount compared to

More information

CD-ROM Version (one-time payment, perpetual use) 5 Seat. 30 Seat SITE

CD-ROM Version (one-time payment, perpetual use) 5 Seat. 30 Seat SITE 1 2 ORDER FORM K-12 Schools, USA (only) For full details of license options and what s included with each purchase visit www.goventure.net and click the PRICES tab. Products to Purchase from 1 and 2 above

More information

School of Business. State University of New York at New Paltz MBA APPLICATION

School of Business. State University of New York at New Paltz MBA APPLICATION School of Business State University of New York at New Paltz MBA APPLICATION THE GRADUATE SCHOOL MBA APPLICATION INSTRUCTIONS School of Business, State University of New York at New Paltz 75 S. Manheim

More information

Immunisation for registered nurses Course outline

Immunisation for registered nurses Course outline Immunisation for registered nurses Course outline IMMUNISATION FOR REGISTERED NURSES Course Dates 1. 03 Feb 24 25 Apr 24 2. 03 Mar 24 23 May 24 3. 07 Apr 24 27 Jun 24 4. 05 May 24 25 Jul 24 5. 02 Jun 24

More information

General Membership Handbook

General Membership Handbook General Membership Handbook Revised: December 22, 2010 Table of Contents 1. Membership as a Research Scientist A. Membership Requirements B. Eligibility C. Application Process D. Fees E. Renewal Process

More information

Frequently Asked Questions About Mobile Banking/Deposit App

Frequently Asked Questions About Mobile Banking/Deposit App Frequently Asked Questions About Mobile Banking/Deposit App What is the myazstcu Mobile App? The myazstcu Mobile App is a service that enables members to access their account information, make deposits,

More information

Taking Care of Business

Taking Care of Business 2015 Taking Care of Business University of St. Thomas Business Office THE UNIVERSITY OF ST THOMAS RESERVES THE RIGHT TO ADD, AMEND, OR REVOKE ANY OF THE CONTAINED RULES, POLICIES, REGULATIONS AND INSTRUCTIONS,

More information

USA WATER SKI 2015 CLUB INSURANCE PROGRAM PRIVATE LAKE LIABILITY APPLICATION FORM

USA WATER SKI 2015 CLUB INSURANCE PROGRAM PRIVATE LAKE LIABILITY APPLICATION FORM THIS APPLICATION IS ONLY APPLICABLE TO THOSE CLUBS THAT OWN OR LEASE A PRIVATE LAKE AND ARE RESPONSIBLE FOR PREMISES LIABILITY FOR THE ENTIRE LAKE ON A 24 HOUR BASIS. CLUB INFORMATION: Club Name: Club

More information

ONLINE BILL PAYING USER AGREEMENT

ONLINE BILL PAYING USER AGREEMENT IBM Southeast EFCU Online Banking ONLINE BILL PAYING USER AGREEMENT Please review the following terms and conditions before enrolling in the Online Bill Paying service. Introduction IBM Southeast Employees

More information

FLORIDA SOCIETY OF MEDICAL ASSISTANTS An Affiliate of the American Association of Medical Assistants

FLORIDA SOCIETY OF MEDICAL ASSISTANTS An Affiliate of the American Association of Medical Assistants FLORIDA SOCIETY OF MEDICAL ASSISTANTS An Affiliate of the American Association of Medical Assistants Adopted 04/24/2015 ARTICLE I - NAME The name of this organization shall be the Florida Society of Medical

More information

Fee: The monthly fee that WW will charge your account is $15.15.

Fee: The monthly fee that WW will charge your account is $15.15. Congratulations on taking the first step in joining Weight Watchers. The following document will provide you directions on how to finalize your enrollment on the Weight Watchers website. Fee: The monthly

More information

APPLICATION PACKET. This application form is interactive. Download the form to your computer to fill it out.

APPLICATION PACKET. This application form is interactive. Download the form to your computer to fill it out. APPLICATION PACKET This application form is interactive. Download the form to your computer to fill it out. 3 TERRACE WAY GREENSBORO, NC 27403-3660 USA TEL: 336-482-2856 * FAX: 336-482-2852 www.cce-global.org

More information

OnPointWeb, LLC Website Service Agreement: Free 3 Month trial

OnPointWeb, LLC Website Service Agreement: Free 3 Month trial OnPointWeb, LLC Website Service Agreement: Free 3 Month trial The purpose of this document is to clarify expectations and set the stage for a mutually fulfilling long term relationship. The following agreement

More information

J-1 Training and Internship Program Application Instruction

J-1 Training and Internship Program Application Instruction J-1 Training and Internship Program Application Instruction Dear WISE applicant: Thank you for choosing the WISE Foundation as your visa sponsor for your J-1 Training or Internship program. The goal of

More information

Login/ Logout RMS Employer Login Go to Employer and enter your username and password in the Employer Login section. Click on the LOGIN NOW button.

Login/ Logout RMS Employer Login Go to Employer and enter your username and password in the Employer Login section. Click on the LOGIN NOW button. Recruitment Management System Version 8 User Guide What is Recruitment Management System (RMS)? Recruitment Management System (RMS) is an online recruitment system which can be accessed by corporate recruiters

More information

Form 312 General Information (Application for Registration of a Foreign Business Trust, Real Estate Investment Trust or Other Foreign Filing Entity)

Form 312 General Information (Application for Registration of a Foreign Business Trust, Real Estate Investment Trust or Other Foreign Filing Entity) Form 312 General Information (Application for Registration of a Foreign Business Trust, Real Estate Investment Trust or Other Foreign Filing Entity) The attached form is drafted to meet minimal statutory

More information

MEMORANDUM. All Eligible Surplus lines Brokers Transacting Business in the State of South Carolina and All Eligible Surplus Lines Insurers

MEMORANDUM. All Eligible Surplus lines Brokers Transacting Business in the State of South Carolina and All Eligible Surplus Lines Insurers MEMORANDUM TO: FROM: SUBJECT: All Eligible Surplus lines Brokers Transacting Business in the State of South Carolina and All Eligible Surplus Lines Insurers South Carolina Department of Insurance, Taxation

More information

Welcome! BUSINESS SET UP ELECTRONIC DEPOSITS

Welcome! BUSINESS SET UP ELECTRONIC DEPOSITS Welcome! Thank you for being part of our Consumers Family! In this packet you will find the forms you need to close accounts and move money to Consumers. We ve made setting up electronic deposits and automatic

More information

WELCOME TO COASTLINE COMMUNITY COLLEGE!

WELCOME TO COASTLINE COMMUNITY COLLEGE! WELCOME TO COASTLINE COMMUNITY COLLEGE! Dear Prospective Student: Thank you for your inquiry regarding. We are pleased that you are considering our college as you make plans for your education. Enclosed

More information

Application for Enrollment

Application for Enrollment Application for Enrollment Course Title: Freight Broker Training/Basic Course Training s: Beginning : Ending : Approved and regulated by the Texas Workforce Commission, Career Schools and Colleges, Austin,

More information

MyABEL Customer Portal. Getting Started Guide

MyABEL Customer Portal. Getting Started Guide MyABEL Customer Portal Getting Started Guide No part of this publication may be reproduced, transmitted, stored in a retrieval system, nor translated into any human or computer language, in any form or

More information

AURP 2015 ANNUAL CORPORATE PARTNER PROGRAM ALL EVENTS

AURP 2015 ANNUAL CORPORATE PARTNER PROGRAM ALL EVENTS AURP 2015 ANNUAL CORPORATE PARTNER PROGRAM ALL EVENTS Be a Visible AURP Partner of Innovation for ALL AURP 2015 Programs The AURP Corporate Partner Program offers select companies the opportunity to participate

More information

Your Guide to Student Accounts at Trent 2015/16

Your Guide to Student Accounts at Trent 2015/16 Your Guide to Student Accounts at Trent 2015/16 Table of Contents Your Payment Schedule...4 Other Important Information & Dates...6 Things to Know about Your Student Account... 7 Fees for the 2015/16 Academic

More information