Engineering Summit

Terms: 30-Day Full Refund for any reason. You will not be charged unless accepted. Dues are for 12 months from the date joined.

Membership Choices:

•	Regular Membership: $ 900	Full access to the other executives, interactive monthly meetings, summaries, webcasts, article insights, book of the month, member directory, online member portal, etc.
•	Team Membership: $ 1900	All member benefits above for continuous development of up to 5 team members (please send the names, emails, and preferred passwords after joining).
•	Benchmark Membership: $ 9500	Above plus twice yearly best practices discussion/exchange with peer company of your choosing (we will invite your choices or agreed substitutes and moderate).

Membership (options above):

Who nominated or wrote you? (if none type "Committee"
which meets twice weekly to consider self-nominations):

Name:

Title:

Company:

Address:

City:

State: Zip/Postal:

Phone:

Email:

Pick Password: Tot. Employees:

Comments:

Payment Method:

Card# (not charged unless accepted):

Expires (mm/yy):

Security Code: (usually 3 digits)

Name on Card (if different):

Billing Address (if different):

City (if different):

State (if different): Zip/Postal:

I agree to the Membership Agreement

Membership (options above):

Who nominated or wrote you? (if none type "Committee" which meets twice weekly to consider self-nominations):
Name:
Title:
Company:
Address:
City:
State:	Zip/Postal:
Phone:
Email:
Pick Password:	Tot. Employees:
Comments:
Payment Method:
Card# (not charged unless accepted):
Expires (mm/yy):
Security Code:	(usually 3 digits)
Name on Card (if different):
Billing Address (if different):
City (if different):
State (if different):	Zip/Postal:
	I agree to the Membership Agreement

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