Company

Company title

Business Address


Business City

Business State

Business Zip + 4

Business Country

Business Phone

Business Fax

Business Email

Business Website

Type of Company & Specialty:

(i.e., GC, CM, Sub. Prof. Service, Consulting, Supplier, Manufacturer. Please be specific regarding product(s).)

Are you an owner of the company?
 Yes    No

Percentage owned by you?
%

Annual Gross Sales:
 Under $500K
 $500K to $2M
 $2M to $5M
 $5M to $10M
 $10M to $25M
$25M+

Indicate Chapter Preference:
You may vote and/or hold elected office only in the Chapter to which you belong. You may attend events of any Chapter at member discount rate.
New York
New Jersey
Connecticut
DC
Northeast Pennsylvania
South Florida


Membership Categories
Final approval of membership is at the discretion of the PWC Board of Directors.

 Corporate A
(Gross income in excess of $5M; entitled to six representatives)
Annual Dues: $750

 Corporate B
(Gross income under $5M; entitled to four representatives)
Annual Dues: $450

 Business
(sole prop./consultant with 3 or less employees; entitled to two representatives)
Annual Dues: $275

For the Corporate or Business categories, please provide the names, titles, telephone numbers, fax numbers, and email addresses of your representatives:

 Individual
(employee of company; entitled to self-representation)
Annual Dues: $225

An individual member's employer does not have membership benefits (e.g., reduced rates for exhibit tables at trade fair and networkings, or member rates for other employees at programs and events).
 Student
(matriculating at accredited institution; non-voting category)
Annual Dues $65

For the Student category:

Are you or your company members of other business or professional associations?  Yes    No
If yes, please list association names: