Prospective members are approved by the Board of Directors. To apply for membership in Commonwealth North, submit the following information:

Name

Title

Company

Address (select Home or Business) Home Business

Street

City

                                                                   State

                                                            ZIP

                                      Daytime phone

                                                            Fax

E-mail address

                                          Home phone

Date of birth (for New Visions and Pioneer memberships)

Type of Membership Standard Pioneer New Visions (under 40) Student Associate Nonprofit

Payment method please invoice me credit card*

If selecting the "pay by credit card" option please print and fill out the credit card authorization form and fax to 276-6350.

Payment cycle Annual Quarterly*

*There is a $15 administrative fee per quarter if quarterly option is selected.

How did you hear about Commonwealth North?

Newspaper
Have attended forums/events
Referred by member
Other