Membership Renewal

Required fields are in bold and denoted with an asterisk (*).

Membership Type:

Business Information:

Prefix:

Dr. Mr. Mrs. Ms.

First Name*:

Last Name*:

Work E-Mail:

Title/Org:

Job Description:

Recruited by which
CITE- MD member:

Address:

City:

State:

Zip Code:

Phone:

Fax:

Home Information:

Address*:

Address:

City*:

State*:

Zip Code*:

Home Phone*:

Home E-Mail:

I would like to sign up for or receive more information about the following committee(s):

Nominations			Public Policy
Scholarships			Ways and Means
Public Relations			Inter-Organizational
Professional Development			Membership Services & Recruiting

Additional Comments:

This concludes the FIRST PART of the membership process. When you click on the continue button below it will take you to the SECOND PART of the process the Order Form. When you enter your credit card number into the Order Form, it is transmitted across the Internet in an encrypted (scrambled) form, then decoded when it gets to the server. The secured pages will show a secured URL ("https://") and a lock sign on your browser. We must receive BOTH PARTS to complete your membership. THANK YOU!

This Site	C o n s o r t i u m o f I n f o r m a t i o n & T e l e c o m m u n i c a t i o n s E x e c u t i v e s	CONTACT US:
Member Organization of CITEŽ & NABTP
		CITE Maryland P.O. Box 1286 Baltimore, MD 21203 410 393-2337
CITE MD Guestbook! CITE MD Guestbook!

Membership Information (Part 1):