TAUD Associate Membership Form

This is to apply for associate membership only. Utilities must use the utility membership form.

Membership Application Superbooster Membership
Company Name:
Contact Name:
Address:
City:
State:
Zip Code:
Phone Number:   xxx-xxx-xxxx
Fax Number:   xxx-xxx-xxxx
E-mail Address:
Web Site Address:  www.
Membership Level  Diamond ($6,000.00)
Platinum ($3,500.00)
Gold ($3,000.00)   
Silver ($2,000.00)
Basic ($400.00) new members or those whom have let their membership lapse one year or more.
Basic ($300.00) existing member renewing membership
In order for your company to be listed correctly in the TAUD Database, Purchasing Guide and the Membership Directory, please select ONE of the following services relating to your line of business:
Total Due $
Pay By Credit Card Credit Card Picture
Pay Later

Credit Card Information
First Name As it appears on card
Last Name As it appears on card
Billing Address
Billing City
Billing State
Billing Zip Code
Card Type
Card Number Enter number without spaces
Expiration Date mm/yy
Amount of Payment $
Do you want a receipt? Yes No
E-mail Address