COMSTEC Member Application

First Name:
Last Name:
Preferred Name/Nickname:
Company/Organization:
Address:
Office Phone:
Cell Phone:
Fax:
Email:
Organizations you are representing:
Membership Level	Annual Fee*
Associations	$100
Business	$100
Educators	$35
Individual	$50
Nonprofit	$50
Student	$25
Please remit payment: COMSTEC, Angel Abbud-Madrid, Treasurer, 1310 Maple Street, GRL Bldg., Rm 234, Golden, CO 80401
Committees of Interest
Talent Development
Resource Development
Outreach
Public Affairs
What can you bring to COMSTEC?
What do you want to get out of COMSTEC?
What do you want COMSTEC to accomplish?

*The Coalition's membership year is from January 1 in any year to December 31 in that same year. Annual membership dues applicable to each member shall be reviewed from time to time by the Board of Directors. The annual membership dues are payable in advance for the ensuing year, on or before the first day of January.