Membership Application

Note: Membership dues are assessed annually in accordance with the categories noted. Please check your membership preference and complete the information below.

Membership Type*
- (A) Corporate -$200: Entitles member to four employee designates on the GTEDC, with the option to add additional members at the rate of $50 per member.
- (B) Business/ Individual -$75: Entitles member to one employee designate on the GTEDC, with the option to add additional members at the rate of $50 per member.
- (C) Educational, Non-Profit, Association -$75: Entitles member to one employee designate on the GTEDC, with the option to add additional members at The rate of $50 per member.
- (D) Student/Retired -$50: Entitles (one) individual on the GTEDC.
Name*
First Last
TItle
Company Name (if applicable)
Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Email*
Enter Email Confirm Email
Do you have a website?*
- Yes
- No
Website Address
Designated Members
For member categories A, B, and C, list the names of all designated members:
First Designated Member
Name
First Last
Title
Second Designated Member
Name
First Last
Title
Third Designated Member
Name
First Last
Title
Fourth Designated Member
Name
First Last
Title

If your organization or company requires an invoice for membership, please email your request to gtedc@saumag.edu.

To pay by credit card, call the GTEDC office at (870) 235-4924.

Membership Application

Designated Members

First Designated Member

Second Designated Member

Third Designated Member

Fourth Designated Member