NACM NATIONAL COMMUNICATIONS CREDIT GROUP

APPLICATION FOR MEMBERSHIP

In order for us to ascertain your company qualifications for the National Communications Credit Group, please complete the following application and return it to:

NACM Tampa Inc.
Attn: Trudy Dodson
PO Box 22827
Tampa, FL 33622

APPLICANT COMPANY NAME:
TELEPHONE: EXT:

MAILING ADDRESS:

FAX NUMBER:

800 NUMBER :

E-mail Address:

CITY / ST / ZIP:

NAME(S) OF INDIVIDUALS(S) RESPONSIBLE FOR CREDIT FUNCTIONS AND WHO WILL ATTEND MEETINGS:

NAME: TITLE:
E-mail address:
NAME: TITLE:
E-mail address:
PARENT COMPANY:

ANNUAL SALES VOLUME:

YEARS ESTABLISHED:

NUMBER OF ACTIVE CUSTOMERS:

MARKET AREA:

NUMBER OF EMPLOYEES:

GENERAL PRODUCTS DISTRIBUTED:

SUBMITTED BY:

AUTHORIZED SIGNATURE & TITLE:

DATE:

We hereby submit application for membership in the National Communications Credit Group and if qualified for admission,  agree to abide by all the Rules, Procedures and Guidelines of the Association and Group. Our Company agrees to an appropriate credit investigation, prior to the NACM Tampa Inc. Board of Advisors approval. We understand that all Companies must be approved by the Association Board of Directors and appropriate Trade Group Boar of Advisors. If required, we also agree to provide a Financial Statement to substantiate our annual sales volume, and a random sampling of our Accounts Receivable. Membership shall be open to any business entity which regularly, in the ordinary course of its business, extends credit to Communications Companies. "Communication Company" (voice & data) is defined as an entity which engages in the sale, installation, or maintenance of telecommunications systems to end users. Exceptions to this definition may be accepted by a majority vote of the group membership.