2016 Membership Application 2016 Membership Fee Due Indicate Selection Tier 1 Governmental - $200.00 1 General Membership + up to 3 Associate Memberships Business - $175.00 Up to 4 Associate Memberships Tier 2 Governmental - $350.00 1 General Membership + 4 Associate Memberships Business - $325.00 5 Associate Memberships Tier 3 Governmental - $525.00 1 General Membership + 5 or more Associate Memberships Business - $500.00 6 or more Associate Memberships General Members are voting members. Both General and Associate Members are eligible for the rate at all LATA conferences. “member” NOTE: Associate Memberships may be used by any employee of the organization interchangeably as long as the total number of conference attendees does not exceed the number of memberships. Please make check payable to: Louisiana Association of Tax Administrators Submit completed application and check to: Louisiana Association of Tax Administrators c/o Thomas H. O’Neal, Secretary/Treasurer P.O. Box 398 Phone: (800) 826-2732 Vidalia, LA Fax: (318) 336-9978 General Membership/Contact Information: Business or Governmental Agency Name: Title General Member/Contact Name: Mailing Address: Zip City: State: Code: Fax Phone #: Ext #: Email: Potential Associate Members (Optional): Name Email 2016 Membership Application (Associate Member List)
2016 Membership Application 2016 Membership Fee Due Indicate Selection Tier 1 Governmental - 1 General Membership + up to 3 Associate Memberships $200.00 Business - Up to 4 Associate Memberships $175.00 Tier 2 Governmental - 1 General Membership + 4 Associate Memberships $350.00 Business - 5 Associate Memberships $325.00 Tier 3 Governmental - 1 General Membership + 5 or more Associate Memberships $525.00 Business - 6 or more Associate Memberships $500.00 General Members are voting members. Both General and Associate Members are eligible for the “member” rate at all LATA conferences. NOTE: Associate Memberships may be used by any employee of the organization interchangeably as long as the total number of conference attendees does not exceed the number of memberships. Please make check payable to: Louisiana Association of Tax Administrators Submit completed application and check to: Phone: (800) 826-2732 Fax: (318) 336-9978 Louisiana Association of Tax Administrators c/o Thomas H. O’Neal, Secretary/Treasurer P.O. Box 398 Vidalia, LA General Membership/Contact Information: Business or Governmental Agency Name: General Member/Contact Name: Mailing Address: City: State: Zip Code: Phone #: Ext Fax #: Email: Potential Associate Members (Optional): Name Title Email 2016 Membership Application (Associate Member List)