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Application Form

Note: All fields in BOLD are required.
Company Name
Primary Contact: First Name
Primary Contact: Last Name

City or town
State or province
Zip or postal code
E-mail address
Phone number (area code and number)
Web site
Business Description
Software & Internet Company Members please provide names and emails for additional company contacts:
CEO Name
CEO E-mail
CFO Name
CFO E-mail
COO Name
COO E-mail
VP Sales/Marketing Name
VP Sales/Marketing E-mail

Select your membership category
Annual Membership
  Choose One:
  Software/Internet Company Member
        with Six or more employees
        Please enter number of         employees
$350 + $15 per employee

  Software/Internet Company Member
        with Five or fewer employees         (worldwide)**
 Affiliate Member
        (Professional Service Firms)
 Associate Member
        (Telecommunication, Electronic &         Hardware Companies)



* Contributions to the Council are not deductible as a charitable expense but are deductible as an ordinary and necessary business expense, subject to restrictions on lobbying expenses. The nondeductible portion of your 2003 dues, which is allocated to lobbying is 14%. Therefore, only 86% of your dues are deductible as a business expense.

** This rate applies only to companies with a worldwide total of five employees or less. Software divisions of larger corporations or local operations of out-of-state companies should use the standard dues rate based upon software/Internet employees in Massachusetts.

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