2018 2019 TEDPA State Membership Dues – ORGANIZATION INFORMATION Primary Contact Person Name Title Agency/Organization Address Address 2 City, State & Zip Phone Number Fax Number Email TEDPA State Membership Dues July 1st, 2018 June 30th, 2019 – Membership Dues Paid ON OR $300.00 per State BEFORE August 1st, 2018 Membership Dues Paid AFTER $325.00 per State August 1st, 2018 Payment Options Please Enter Your Total Membership Dues Fee & Select Your Payment Type Total Membership Amount: Check Please Attach Check – $ Purchase Order Please make check payable to: TEDPA Andy Leffler, Treasurer c/o InTRAC 7702 Woodland Drive, Suite 130 Indianapolis, IN 46278 Email: Please Note Members shall be limited to those individuals, contractors to the administration and their staff who have, or expect to have, direct responsibility for the administration or oversight of Specialized Telecommunications Equipment Distribution Programs. Members will have voting privileges and will also have access to the members only section of the TEDPA website. During TEDPA business meetings, each state shall have one vote. Vendors are not eligible unless they are the legislatively appointed administrator.
2018 – 2019 TEDPA State Membership Dues ORGANIZATION INFORMATION Primary Contact Person Name Title Agency/Organization Address Address 2 City, State & Zip Phone Number Fax Number Email TEDPA State Membership Dues July 1st, 2018 – June 30th, 2019 Membership Dues Paid ON OR BEFORE August 1st, 2018 $300.00 per State Membership Dues Paid AFTER August 1st, 2018 $325.00 per State Payment Options Please Enter Your Total Membership Dues Fee & Select Your Payment Type Total Membership Amount: $ Check – Please Attach Check Purchase Order Please make check payable to: TEDPA Andy Leffler, Treasurer c/o InTRAC 7702 Woodland Drive, Suite 130 Indianapolis, IN 46278 Email: Please Note Members shall be limited to those individuals, contractors to the administration and their staff who have, or expect to have, direct responsibility for the administration or oversight of Specialized Telecommunications Equipment Distribution Programs. Members will have voting privileges and will also have access to the members only section of the TEDPA website. During TEDPA business meetings, each state shall have one vote. Vendors are not eligible unless they are the legislatively appointed administrator.
2018-TEDPA-State-Membership-Dues.docx