Membership Application

Online Membership Renewal

To renew, just complete this form and hit the "submit" button.

JOIN THE SOFTWARE COUNCIL or
RENEW YOUR MEMBERSHIP TODAY!
RECEIVE A FREE 5-USER SET OF GOLDMINE CRM SOFTWARE
Valued Over $1,000

Otherwise, print this form, fill it out and send it with your enclosed check to:

The Software Council of Southern California
2461 208th Street, Suite 202
Torrance, CA 90501

Note: Please make check payable to the Software Council of Southern California.

Or, you may fax your completed application to (310) 224-1993. A Software Council representative will contact you if additional information is required.

Company Contact 1:		Contact 2:
Title 1:		Title 2:
	Renew my membership
Company:
	Headquarters Branch Office
Address:
City:
State:		Zip Code:
Country:
Phone 1:		Phone 2:
Fax:		Fax 2:
E-Mail 1:		E-Mail 2:
Membership Category:
Company Description:
Date Founded:
No. of Employees:
No. of Locations:
Est. Annual Revenue:
Web Site:

Membership Rates
Industry		Associate
Business must develop/provide software or programming services in Southern California Business must publish software in its own name, in Southern California Business must be a serious, risk-taking venture, not just a hobby		Provides support services to Southern California software industry
1-3 Employees	$250	1-25 Employees	$650
4-9 Employees	$350	26-50 Employees	$950
10-25 Employees	$450	51-100 Employees	$1,500
26-50 Employees	$550	101-200 Employees	$2,000
51-100 Employees	$1,000	200+ Employees	$3,000
101+ Employees	$1,500

Name on Card

Card #:

Exp. date:

Total Membership Dues: Add $25 for One-Time New Member Application Fee

Please Note: Company memberships entitle all company employees to special
member rates and privileges.