NYS Forum

The "primary contact" for each corporate member should be one individual within the corporation with responsibility for activities in state and/or local government for her/his organization. The primary contact may actively participate in the NYS Forum meetings and committees. Memberships are held in the name of the corporation, not the individual primary contact.

The "associate contacts" are limited to a maximum of two additional individuals per corporation, who may also actively participate in the NYS Forum meetings and committees. Memberships are held in the name of the corporation, not the individual associate contacts.

Associate Contact 1 Address:

Same as Primary Contact

--OR--

Associate Contact 2 Address:

Same as Primary Contact

--OR--

Please specify whether your corporation is NYS certified as a M/WBE:

WBE (a copy of the NYS Certification is required)

Yes

No

 

MBE (a copy of the NYS Certification is required)

Yes

No

 

Please specify whether your corporation is NYS certified as a Small Business as defined in New York State Finance Law, Article XI.8 (requires a signed letter indicating the company complies with the four criteria defined in NYS Finance Law including resident in the state, independently owned and operated, not dominant in its field and employs less than one hundred persons):

NYS Small Business

Yes

No

Do not send cash. All membership fees are nonrefundable and nontransferable to another corporation.

Online (Secure Credit Card Visa or Master Card Only)

Check or money order payable to NYS Forum (an invoice will be sent to the Primary Contact)

Do you know someone else who might be interested in receiving an Introductory Packet to the IT Corporate Roundtable? May we reference you when contacting them?

Yes

No