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Membership Application

2440 Western Avenue, Suite 709
Seattle, WA 98121
USA
1.206.374.2263 facsimile

ILPF membership dues for 2003 have been set by the Board of Directors at US$20,000 for twelve months. The ILPF recognizes two billing periods, January 1- December 31, 2003 and July 1, 2003- June 30, 2004. Member companies which submit an application on or after July 1, 2003 may request either a six month membership (July 1- December 31, 2003) prorated at $US10,000 or the full twelve month membership at US $20,000.

Please choose a form application from the following three options:

Download the Word version (.doc) by clicking here.
Download the PDF version (.pdf) by clicking here.
If you do not have the Adobe Acrobat reader, please download here
Apply online by submitting the following information:

1.	Name of company

2.	Contact information for headquarters
	Street Address 1:
	Street Address 2:
	City:
	Province/State:
	Postal Code:
	Country:
	Main Telephone Number:
	Main Fax number:
	Company URL:

3.	Brief description of company's business

4.	Each ILPF member company holds a seat on the Board of Directors. Please indicate the individual employee designated to the Board Seat.
	Name of Person:
	Job Title:
	Deparment:
	Street Address 1:
	Street Address 2:
	City:
	State/Province:
	Postal Code:
	Country:
	Business Email:
	Business Phone:
	Businnes Fax:
	Mobile Phone:
	Alternate Email:
	Assistant's name:
	Assistant's Phone:
	Assistant's Email:

5.	Primary contact person
	Name of Person:
	Job Title:
	Department:
	Street Address 1:
	Street Adress 2:
	City:
	State/Province:
	Postal Code:
	Country:
	Business Email:
	Business Phone:
	Business Fax:
	Mobile Phone:
	Alternate Email:
	Assistant's Name:
	Assistant's Phone:
	Assistant's Email:

6.	Person to whom invoice is to be sent
	Name of Person:
	Job Title:
	Department:
	Street Address 1:
	Stree Address 2:
	City:
	State/Province:
	Postal Code:
	Country:
	Business Email:
	Business Phone:
	Business Fax:
	Mobile Phone:
	Alternate Email:
	Assistant's Name:
	Assistant's Phone:
	Assistant's Email:

7.	Person(s) who will receive all official communications (the "Development Committee" list) If you wish to add more names, please let us know.
	Name of Person:
	Job Title:
	Department:
	Street Address 1:
	Stree Address 2:
	City:
	State/Province:
	Postal Code:
	Country:
	Business Email:
	Business Phone:
	Business Fax:
	Mobile Phone:
	Alternate Email:
	Assistant's Name:
	Assistant's Phone:
	Assistant's Email:

9.	Person(s) whom you wish to receive the weekly newsclip service.
	Name of Person:
	Job Title:
	Email:
	Name of Person:
	Job Title:
	Email:
	Name of Person:
	Job Title:
	Email:
	Name of Person:
	Job Title:
	Email:
	Name of Person:
	Job Title:
	Email: