INSTITUTE for SUPPLY MANAGEMENT, INC.
MEMBERSHIP OR TRANSFER APPLICATION

TYPE OF MEMBERSHIP: REGULAR ASSOCIATE STUDENT BUSINESS

I wish to become an ISM member through Greater New Orleans Affiliate Code 02/420
ISM ID (if known)
Please check the appropriate box:
New Member Past Member
Current Member, but transferring from

        (Affiliate Name)
I am replacing the following member* in my company:
Member's name
Company name
City/State/Zip   
*Affiliate Officer: Above name must appear on a deletion form.
Annual ISM/Affiliate Dues         
(For dues information, reference enclosed letter or
contact ISM Cust. Svc. at the number listed below.
Dues:                              $200.00
ISM Administrative Fee:                                 $20.00
Affiliate Administrative Fee:$  5.00
Affiliate Initiation Fee:                      
Other:                                            
TOTAL:                           $
 Dues, contributions, or gifts to this organization are not tax deductible charitable contributions for income tax purposes. Dues may, however, be deductible as a business expense.
Are you interested in serving on a committee?
Yes No
Industry Code:
(Enter a 3 digit code from the list by clicking here.)
EDUCATION: Please select highest level completed:
H.S.Assoc.Student
Bachelor'sMaster'sOther
Date of Birth (optional) 		Are you a C.P.M.? Yes No
Are you a CPSM.? Yes No
Do you hold other professional designations? If so, please list.
What is your involvement in the purchasing or materials process?
Are you involved in selling? Yes No If so, explain:
Mr. Mrs. Ms. Miss Dr.
First Name                            MI   Last Name

Title                                                   Company Name

BUSINESS (Please check the preferred mailing address.)HOME



City/State/Zip Code

Country/Postal Code


City/State/Zip Code

Country/Postal Code


Business Phone Number**                           Fax Number**                                               Home Number**
**For international numbers, please include country and city codes.

E-mail (preferred)   
METHOD OF PAYMENT: (U.S. funds only)Personal or Company check is enclosed.
Please charge my Visa MasterCard American Express Personal cardCorporate card
Charge Card #    Exp. Date
Amount to be charged Name as it Appears on Card
I agree that I have read and will abide by the ISM Bylaws, Principles and Standards of Purchasing Practice, and Statement of Antitrust Policy.
Signature_____________________________________________________ Date__________________
ISM members receive Inside Supply Management magazine for a $12 portion of the national membership fee.		 
Return to:    ISM-GNO, Inc.
              Attn: membership Chair
              P. O. Box 52155              
              New Orleans, LA 70152
 
APPROVALS FOR AFFILIATE/ISM USE ONLY
 ISM__________________ Date ____________
 Affiliate _________________ Date ____________ 
 Other  __________________ Date ____________
ISM USE ONLY
P/C Ck# __________________ Amount $ ________________ A/C ______________ / ______________
Approval # __________________________ Date Entered _______________ Initials ________________
ISM, P.O. Box 22160, Tempe AZ 85285-2160, 800/888-6276 or 602/752-6276, ext. 401 (Customer Service)
http://www.ism.ws