Transfering Member
Application Form
Home
About Us
Calendar
Education
Employment
Membership
Newsletters
Purchasing Terms

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Transferring Members Only

ISM ID# (if known)
I am transferring from (please list former affiliate name)
 
First Name
Middle Initial
Last Name
Suffix
Are you a... CPSM C.P.M.?  A.P.P.?  CPIM?  Other?
Preferred Address Home Business
Company Information  
Company Name
Job Title
Involvement in Purchasing
Address 1
 Address 2
City
 State
Zip
Business Phone
Business Fax
Business Email (an email address is required as most communication with members is via email)
Industry
I do NOT wish to receive information about Nevada activities
Home Address   (this information will not be shared)
 Address 1
Address 2
City
State
 Zip
Home Phone
Home Fax 
Home/Personal Email
Optional Information  
Birth Date   (mm/dd/yyyy)
Gender Male Female
Education  
Payment Information  
Credit Card Mastercard Visa American Express Diners Club
 Invoice Me  Call me for my credit card information Payment Mailed
Name on card
Card #
 Exp Date (mm/yyyy)
Amount:    Annual Cost - $140.00 (transferring member)  $160.00 (new member)

Actual costs will be prorated through May 31st.
Comments

If you are concerned about the security of your credit card number on the Web, please consider using this order form. Leave the card number area blank and select the option for 'Call me for my credit card information'. Someone will contact you to obtain your payment information.  You may also mail payment to:
    ISM-Nevada
    1709 Splinter Rock Way
    North Las Vegas, NV 89031

By submitting this application, you agree to abide by the ISM Bylaws, Principles and Standards of Purchasing Practice, and Statement of Antitrust Policy. (after reading policy, click back button to get back to this form.)

     Back to Top