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Please indicate whether you are joining or renewing:

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Company Name
Primary Contact: First Name
Primary Contact: Last Name
Title
Address
City or town
State or province
Zip or postal code
E-mail address
Phone number	(area code and number)
Web site
Business Description

If you are a Technology Provider, please indicate your primary business focus:

Enterprise Software Open Source RFID

Robotics Software as a Service Infrastructure

OSS Wireless Security Other

If you are a Technology User, please indicate your primary business focus:

Health Care Life Sciences

Financial Services Retail

Other

If you are an Affiliate (professional Service firm), please indicate your primary business focus:

Accounting Legal Marketing/PR

Bank Insurance Management Services

Venture Capitalist Other

Membership Dues

Technology Provider:
A company whose primary business is the sale of technology products or services. For Providers headquartered in Massachusetts, membership dues are calculated based on the number of worldwide employees. For Technology Providers headquartered out-of-state, dues are calculated based on Massachusetts employees only.

Technology User:
A company whose primary business, while aided by the use of technology, is not the sale of technology products or services (i.e., financial services, health care, life sciences, retail etc.). Membership dues are based on the number of employees in the IT department.

Membership dues for the categories above are calculated based on the number of employees as noted above.

Membership Dues Formula 1-9                $250 10-24           $500 25-49           $1,000 50-99           $1,500 100-199       $2,500 200-349       $5,000 350-499      $7,500 500-749      $10,000 750-999     $12,500 1000+         $15,000

Affiliate:
(Professional Services Firm)
A company that provides services to the technology industry, including banks, law firms, accounting firms, venture capital firms, public relations firms and others.