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MEMBERSHIP

Membership 2007 / 2008

Dues and Assessments Questionnaire

(Calendar Year 2005 Sales)

Company Name
Address
City
State
Zip Code
Send Bills to Attention of
 
First Name
Last Name
Title
Billing Address (if different)
 
Address
City
State
Zip Code
 
Please list subsidiaries/divisions under their appropriate market area(s) below. Also include any companies or lines of business acquired since 1/1/2005 and include their 2005 Eligible Sales even though these companies may not have been part of your company for the full period. The figures reported below are used as a dues base for your company as it is now.
 
 
Product /
Market Area		   Calendar 2005*Eligible Sales
 
School $
Higher Education $
Trade (General Publishing) $
Trade (Mass Market Paperback) $
Direct Marketing $
Professional /
Scholarly Publishing		 $
Total Eligible Sales $
(*If calendar year sales are difficult to calculate, sales for the fiscal year ended in 2006 may be used. )
 
Please enroll my company in the following division(s):
 
 School
 Professional / Scholarly Publishing School
 
Please list all subsidiaries / divisions included in the above reported sales.
(You may attach a list if you prefer.)
 
 
Please list companies/lines of business acquired and their
2005 calendar year sales included above.
 
 
If you have any questions, contact Jay Keeshan at the Management Practice Inc. (203) 973-0535. Please return this form by mail or fax directly to the Management Practice Inc., 216 W. Hill Road, Ste. 200, Stamford, CT 06902, Fax (203) 978-9034. APPROVED (PLEASE PRINT NAME)
Signature
Name
Title

 

Click Here to Print Form

 

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