2010 CAMEO Membership Form

Thank you for your interest in Joining CAMEO!

Please provide your organization’s information in the form provided. Be sure to fill out as many fields as possible so that we can better understand your needs and provide you with the necessary services. Keep in mind that the more information you give, the better we can serve you!

Membership dues range from $75- $500 depending on budget and type of organization. After completing the form you will be given the option to pay by credit card or check. There will also be a downloadable invoice template provided after filling out the form.

1. Please provide your contact information.

Company Name Required Question

Street Address Required Question

Apt/Suite/Office

City

State

Postal Code Required Question

Country

Phone Number Required Question

Fax Number

Mobile Phone

URL

2. Please provide your contact information.

First Name Required Question

Last Name

Title

Email Address Required Question

Phone Number Required Question

3. Please include contact information of other organization representatives.

	First Name	Last Name	E-mail	Title
Rep 1
Rep 2
Rep 3
Rep 4

4. Organization Type Required Question

	Non-profit Service Provider
	Government Agency
	Consortium/Coalition
	Individual
	Corporation
	Association
	Other