IPC-CM-770D-1996.pdf - 第176页

Northbrook, Illinois 22 15 Scnders Rod 60062-6 135 T 4 847 509.9700 Fa 847 509.9798 COPYRIGHT Association Connecting Electronics Industries Licensed by Information Handling Services COPYRIGHT Association Connecting Elect…

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APPLICATION

FOR

SITE MEMBERSHIP

Site Information:

Company Name

Street Address

City State Zip Counhy

Main Phone No. Fax

Primal7 Contact Name

Title Mail Stop

Phone Fax e-mail

Alternate Contact Name

Title Mail Stop

Phone Fax e-mail

Please check one:

$1,000.00 Annual dues for Primary Site Membership (Twelve months of IPC membership begins from the time the application

and payment are received)

$800.00 Annual dues for Additional Facility Membership: Additional membership for a site within an organization where

another site is considered to be the primary IPC member.

$600.00** Annual dues for an independent PCB/PWA fabricator or independent EMSI provider with annual sales of less than

$1,000,000.00. **Please provide proof of annual sales.

$250.00 Annual dues for Government

AgencyLJniversityhot-for-profit

organization

TMRC Membership

Please send me information on Membership in the Technology Marketing Research Council (TMRC)

AMRC Membership

Please send me information for Membership in the Assembly Marketing Research Council (AMRC)

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Mail application with

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FaxlMail application with

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I I I I

r""""""""""""""""""""-

I I

Dept. 77-3491 221

Sanders Road

Chicago,

60678-3491 Northbrook,

60062-6135

Tel: 847 509.9700

Fax: 847 509.9798

PLEASE

ATACH

BUSINESS

CARD

OFFICIAL

REPRESENTATIVE HERE

L""""""""""""""""""""-~

Licensed by Information Handling Services

Northbrook,

Illinois

Scnders

Rod

60062-6

135

847 509.9700

847 509.9798

Licensed by Information Handling Services