Membership Application

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The undersigned company does hereby make application to Business Products Council Association for regular membership and represents that such dealer is principally a distributor in the office systems business. This application must be approved by the BPCA Board and eventually the entire membership. Dues shall be returned should the membership not be approved. Once approved, the dues shall be deemed fully earned and non-refundable.

Company name: *

Address Line: *

City: *

State: *

Zip: *

Phone number: *

Fax number: *

E-mail address: *

Website address: *

Chairman: *

President: *

Secretay: *

Treasurer: *

States and counties in which you currently provide sales & service coverage: *

Primary product categories and manufacturers your dealership is authorized to sell i.e., Ricoh-copiers & fax; Panasonic-fax) :

Other office systems companies owned in part or in total by any of the above officers - include city and state : *

Total number of employees: *

Annual revenue: *

Tax ID number:

Condition 1: *

The applicant understands that the chief executive officer, managing partner or proprietor of the dealership shall be the Primary Voting Member in the BPCA in the event this application is approved. Each Company is entitled to one vote in the affairs of the Association to be cast by its Primary Voting Member. One person only, the Primary Vothing Member, will receive BPCA e-mails and mailings unless an alternate is specified.

Condition 2: *

I hereby apply for membership in BPCA. I understand that a dues payment of $2,100 is due at the time I submit this application. If not approved for membership, the fee will be credited to my account.

Name and title of applicant: *

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Membership Application

The BPCA would like to thank the sponsors of our 2011 Fall Owners Meeting