**please print out this form, fill it out, and mail to the address below**

Company Name_______________________________________________________

Address_________________________________________________________________________________

City_________________________________________State_____________________Zip_______________

Telephone____________________Representative_______________________________________________

FAX____________________________________________E-mail____________________________________

Associate Members:  Products or Services______________________________________________________

Check One:  Voting Membership
         Associate Membership

Sponsor (if any)______________________________________________________________

Voting Member:        Dues of $125.00 are payable for fiscal year Jan. 1 to Jan. 1

Associate Member:        Dues of $62.00 are payable for fiscal year Jan. 1 to Jan. 1

Payment Enclosed

Mail To:

P.O. Box 83926  ·  Portland, Oregon  ·  97283-0926