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MEEC Membership Application


Team With The Winners - Join MEEC today!

The business organization for certified minority suppliers that provide
 the following services:

◘Information Technology        ◘Telecommunications         ◘Manufacturing      ◘Finance    ◘Construction ◘Utilities    
◘Healthcare      ◘Education      ◘Transportation      ◘Electronics

MEMBERSHIP APPLICATION

Name:   _______________________________________________ Title: ______________________

Business Name:    __________________________________________________________________

Address:  _________________________________________________________________________

City: ____________________________________________  State:_________  Zip: ______________

Today’s Date: ____/____/____    Ph(_____)___________________  Fax: (____)________________

Type of Business: ___________________________________________________________________

Years In Business: _________ D & B #: _________________________________________________

MBE Certification: _________________________________________________________________

Client Listing: _____________________________________________________________________

__________________________________________________________________________________

E-Mail Address:     __________________________________________________________________

Website Address: ___________________________________________________________________

Select Appropriate MEEC annual membership:

     □  Small/Med. Business           $500         
      □  Major Corporations/Government        $1000     


□ American Express       □ MasterCard        □ VISA
Credit Card #______________________________________________________________

Exp Date: ____/____     Signature: ___________________________________________


Please enclose check with completed form and mail to:
MEEC, P.O. Box 5199, Woodbridge, Virginia 22194
For more information call (703) 730-4091            (703) 730-4092 fax
vpwilliams@comcast.net        www.meecouncil.com
        

“Building Relationships in Both Public and Private Sectors”

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