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DUES SCHEDULE
INDUSTRY MEMBERS -
Total Employees	Dues
1-10	$225
11-100	$400
101+	$1000
Educational Institutions/ Economic Development Organizations	$400
AFFILIATE MEMBERS -
Total Employees	Dues
1-10	$300
11-100	$1000
101+	$1500
SPONSOR MEMBERS -	$4000
STAFFING COMPANIES -	$2000 + Affiliate Membership fee

Please either fill in this form and submit it and then mail a check to the address below OR print this form, then fill it out and mail together with a check to the address below.

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Company Name:

Contact:

Address:

City:

State:

Zip Code:

Phone:

Fax:

E-Mail Address:

Type of Business:

Number of Employees:

Dues $:

MAKE CHECK OUT TO:
ATTN:
AND MAIL TO:

LISTnet
Peter Goldsmith
734 Walt Whitman Road
Suite 402
Melville, NY 11747

Please note this is a contract for membership in LISTnet. If you need more information on joining before submitting this form, please contact LISTnet at (631) 224-4400.

To membership cancellations must be in done in writing and emailed to martha@listnet.org