MAIL IN YOUR MEMBERSHIP APPLICATION/RENEWAL TODAY!


Contact Name __________________________________________________________________

Title _________________________________________________________________________

Company _______________________________________________________________________

Today's Date __________________________________________________________________

Address _______________________________________________________________________

City/State/ZIP ________________________________________________________________

Phone ______________________________________ Fax ______________________________

Email _________________________________________________________________________

Are you currently a WPPC member? __ Yes   __ No


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Please enclose your check, payable to WPPC, for annual dues (check one):

__ Regular member - individual: $50       __ Regular member - corporate: $150

__ Associate member - individual: $75     __ Associate member - corporate: $200

__ I know of someone who may be interested in information about the WPPC.
   Please contact him/her:

   Name __________________________________ Email ______________________________

   Company _______________________________ Phone ______________________________

__ I prefer to be removed from your mailing list.


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We welcome your comments: _____________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________


To reduce our postage costs for mailings, can we contact you via e-mail with
announcements? __ Yes   __ No


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Mail this form with your check to:

WPPC
100 Interstate Blvd.
Edgerton, WI 53534-9399