Organization Information
Name of Organization* (as it should appear in the Membership Directory)
Address
Address (line 2)
City
State/Province
Zip
Country
Phone Number*
Fax Number
Web Site

Organization Type
Select all that apply
Accounting/Auditing Association/Foundation Attornney Bank/Lender Clearinghouse	Computer Hardware Provider Computer Software Provider Consulting Service Foundation Guarantor Agency	Publisher Scholarship Provider Secondary Market Servicer State or Federal Agency
Other (please specify)

Dues Calculation Details
Dues are based on your organization's annual revenue. Dues will be prorated through June 30, 2010, if applicable. Prorated dues will be calculated on the next page.
If your Annual Revenue Is:	Tier	Yearly Dues	Entitlements	Web IDs	Directory Listings
$0-500,000	Tier 1	$1,420.00	1	6	6
$500,001-1,500,000	Tier 2	$3,100.00	3	8	8
$1,500,001-4,000,000	Tier 3	$4,855.00	6	11	11
$4,000,001 or more	Tier 4	$6,745.00	10	15	15
Membership start date for 2009-2010 year	November December

Description
You may enter a two hundred (200) word, one (1) paragraph description of your company. This description will appear with your company's listing in the NASFAA Buyer's Guide. There is no charge for this service. Your description will be edited for typos only. Please proof it carefully upon entry.
Words remaining:

Primary Contact Information
All NASFAA member organizations must designate one staff person as the Primary Contact.
Primary Contact Name*
Primary Contact Title
Primary Contact Title Category	Asst./Assoc. Director Aid Officer Analyst Business Officer Dean Director Manager President Vice President Other
Primary Contact Email*
Primary Contact Phone (if different than FAO number)
Address (if different)
City (if different)
State/Province (if different)
Zip (if different)
Country (if different)