registration

GMIS Membership Registration

Organization Name:

Organization Url

Member Type:

Address:

City:

State:

Zip Code:

Contact Last Name:

Contact First Name:

Contact Title:

Phone:

Fax:

Contact Email:

IT Budget:

Please check one. The regular membership fees are based on your agency's annual IT budget:

<$250,000; membership fee is $75.00
>$250,000 and <$1,000,000; membership fee is $150.00
>$1,000,000 and <$3,000,000; membership fee is $300.00
>$3,000,000; membership fee is $400.00

If you are applying for a corporate membership please check one:

Small Business Partner $750.00
Bronze preferred Vendor with up-graded benefits $3,000.00
Silver Partner additional benefits of State Chapter recognition for annual conferences $6,000.00
Gold partner with additional exposure to GMIS membership $10,000.00
Platinum Partner for the most PRESTIGIOUS organization that will receives all benefits.

Payment Method:

Print & Mail Check Credit Card