WNYECmembershipdues2017
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This document is a 2017 membership dues form for the Western New York Employment Consortium. It requests the member's contact information, including name, title, agency, address, phone number, and email. It also asks the member to indicate if they intend to continue or begin involvement with the consortium in 2017 and whether they are a new member. It provides instructions to make a $50 check payable to the WNY Employment Consortium and mail it to the specified address and contact by January 1, 2017 to December 31, 2017.
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WNYECmembershipdues2017
- 1. 2017 Membership Dues January 1, 2017 to December 31, 2017 Yes, I intend to continue/begin involvement and participation in the Western New York Employment Consortium. Date:___________________________ Name:_____________________________________________________ Title:_______________________________________________________ Agency:____________________________________________________ Address:___________________________________________________ City:_____________________________________Zip:_______________ Telephone:_______________________________Extension:__________ Email:__________________________________Fax:_________________ Amount Enclosed: $_____________ New Member(Y) (N) (Circle One) Make Checks in the amountof $50.00 per memberto: WNY EMPLOYMENT CONSORTIUM Mail Checksto: WNY EmploymentConsortium C/O People Inc ATTN: Tina Polito 4286 Delaware Ave, Tonawanda,NY 14150 (716) 694-6630 | tpolito@people-inc.org