Printable Application Form

Membership Requirements
The undersigned hereby makes application for membership in the Regional Technology Organization (RTO). It is understood by the firm or individual that this application is subject to the approval of the RTO Board of Directors. The applicant and the Regional Technology Organization agree that this membership will remain in force until the firm or individual submits awritten resignation or until the membership is revoked by the RTO Board of Directors.

Local Chamber of Commerce Membership:
  Annual Membership (12 months based on join date) $100.00   Late Fees (After 60 days from date of invoice)  $20.00

Non-Chamber of Commerce Membership:
  Annual Membership (12 months based on join date) $200.00   Late Fees (After 60 days from date of invoice)  $20.00

Student Membership
  Annual Membership (12 months based on join date) $50.00  Late Fees (After 60 days from date of invoice) $20.00

Business Name  Application Date
Business Address
City State Zip 
Contact Person
Phone Fax
Email
Founded Date TTL Employees
Personnel Person SIC Code
Dues Amount Payment Option
Business   Description  Business Type
Owner Name