STATE USE PROGRAMS ASSOCIATION
2008 CORPORATE MEMBERSHIP APPLICATION
NAME OF ORGANIZATION_________________________________________________
INDIVIDUAL REPRESENTING ORGANIZATION_____________________________
ADDRESS__________________________________________________________________
CITY__________________________________STATE__________ZIP_________________
PHONE__________________________________FAX______________________________
EMAIL_____________________________________________________________________
WEBSITE___________________________________________________________________
I, _________________________________, am the duly-appointed representative of
Name
_____________________________________ to the State Use Programs Association.
CNA Name
__________________________________________ _______________________
Signature Date
2008 CNA Membership Dues Structure (Based upon most recent annual State Use Commission Revenue): $0 - $1,000,000 $ 500
$1,000,001 - $3,000,000 $1,000
$3,000,001 + $1,500
State Agency $ 500
Please send this completed form and a check made payable to SUPRA to:
Debbie Ignatz
State Use Programs Association
900 Sycamore Lane, #101
Woodstock, GA 30188