I. Membership Data

Company
Street/P.O. Box
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Telephone
FAX
E-mail
Website Address

Member Contacts

(This in no way limits the number of individuals who may participate in MCAA programs or meetings.)

Official Voting Representative (Name and Title)

Alternate Voting Representative (Name and Title)

Services Information

Within the following general classifications, the ones checked apply to our company's services.

Trade Publications
Market Research and Analysis
Channel Partnership Consulting
Merger and Acquisition Intermediary
Management Strategies Consultant

NOTE: Our services do not fit into the above major divisions. Our services are best described as:

In order to speed the processing of this application, please mail appropriate publications or capabilities literature to:

MCAA
P.O. Box 3698
Williamsburg, VA 23187

Corporate Information

Name:

Street:

City:

State:

Zip:

Number of employees:

Year Founded:

II. Eligibility for Membership

• Applicants for Consultant/Press membership must be a publication or consultant with a demonstrated interest in the measurement, control and automation industry.
• Applicant must be financially sound and of good reputation
• Independent Consultant is a consultant firm with less then three (3) employees.

III. Rights of Consultant / Press Membership

1. Identification as a member of the Association, including listing in the Membership Directory of the Association;.

2. Attendance at meetings of the Association; one registration is included in the dues paid to the association.

3. Complimentary subscription to all general publications and other Association communications.

4. Use of membership plaque for display and member logo for publications/mailings.

5. May participate in or receive data from any statistical program or suvey which is based upon manufacturers’ data where provision has been made to collect distributor data as a part of the survey or as a separate group

IV. Dues

For consultancies and trade press dues are fixed at a flat fee of $2,490. For Independent Consultants (less than 3 employees), dues are fixed at a flat fee of $1,355.  Association dues are an annual obligation for the fiscal year. PLEASE NOTE: Your membership dues are not deductible as a charitable contribution for Federal Income tax purposes. However, your dues are deductible as an ordinary and necessary business expense. No portion of the dues is used for lobbying.

Dues for MCAA now include one registration to the annual meeting of the Association, the Executive Forum, which is held in the spring of each year.  Additional executives from a member company may attend at a reduced fee, to be determined each year.

Dues may also be paid in annual, semi-annual, quarterly or monthly installments.  Annual dues must be paid on an anniversary date before December; installment payments require a payment in July and regularly thereafter; installment payments include a small processing fee and will be invoiced by the Association.

Trade Press or Consultancy        Independent Consultant

V. Agreement

We pledge our financial support to the Association through payment of ANNUAL dues. We understand that membership in the association is an ANNUAL obligation and dues are fully payable even if installment payments are elected.

Signed:

Date of Application:

You should print this form before submitting it.