Submit by fax or mail
  Annual Membership Dues:
  Not for profit/government:
1 - 75 employees:
76 - 120 employees:
over 120 employees:		   $100.00
$150.00
$300.00
$500.00
     
Payment Information:
  I would like to become a member of the New Hampshire Travel Council.
Enclosed are my annual dues of $____________.
Please check one:    
Check Amex
Visa MasterCard
If payment by check, make check payable and mail to:
New Hampshire Travel Council, PO Box 3935, Concord, NH 03302-3935
If paying by credit card, fax completed form (603-226-1829) or mail.
 
     
Credit Card Information:
_____________________________________________________________
Account Number                                                                Exp. Date
   
    _____________________________________________________________
Card Holder Name
   
    _____________________________________________________________
Signature                                                   3-digit CV No. (back of card)
   
   
Business Information: 
________________________________________________________________
Business Name
         
________________________
Date		 ________________________________________________________________
Address
         
________________________
Daytime Telephone		 ________________________________________________________________
City/Town State               Zip
         
________________________
Fax		 ________________________________________________________________
Web Address
         
  ________________________________________________________________
Business Description: 10 - 15 words
         
  ________________________________________________________________
         
Member Information: 
  ________________________________________________________________
Primary Contact/Title
   
         

Member Listings:
Each member company will have an opportunity to list five key employees in the Travel Council web site member directory. Each one will be added to our mailing list.

Mailing List:
If you have other employees that would like to receive the Travel Council newsletter, just click to send us an email with their names and email addresses

   ________________________________________________________________
Primary Contact Email Address
       
  ________________________________________________________________
Employee 2 / Title
 
       
  ________________________________________________________________
Employee 2 Email Address
 
       
  ________________________________________________________________
Employee 3 / Title
 
       
    ________________________________________________________________
Employee 3 Email Address
   
         
    ________________________________________________________________
Employee 4 / Title
   
         
    ________________________________________________________________
Employee 4 Email Address
         
    ________________________________________________________________
Employee 5 / Title
         
    ________________________________________________________________
Employee 5 Email Address
         
    ________________________________________________________
     Authorized Signature   Date