COMPANY CONTACT INFORMATION:(ALL fields required; if the field is not applicable enter n/a)

Legal Name		Year Started

Street Address		City		State		Zip

Administrative Phone		Reservation Phone
Fax Number		Toll-Free Number
Company Email		Web Page

CHECK ALL THAT APPLY TO YOUR BUSINESS:

Click on the appropriate dollar amount to indicate your business size
and preferred billing frequency. * Annual rates must be received by July 1st to be eligible for 10%.

ISLAND & CATEGORY: One Island and Category is included with your Membership Dues. Each additional Island is a charge of $20 per month and each additional Category is $5 per month. These will be added to the dues above at the same scheduled billing frequency. (Quarterly, Semi-Annual or Annual)

OPTIONAL MARKETING OPPORTUNITIES AT NO ADDTIONAL COST: Check to indicate which program(s) you would like to participate in.

Officer of the Company				Title
Direct Email		Direct Phone		Mobile Phone