Thank you for your interest in MITS. To become a MITS member, please complete the information below. Members, through their initial and annual membership contribution are listed as a MITS sponsoring organization, have full access to all documents and information on the MITS website, can participate in a leadership position and on all active committees and task forces. The annual fee is established annually, but is currently capped at $500.00. Initial Membership is $1,000.00.

indicates a required field.

Last Name:	First Name:
Email address:
Choose a password: (Minimum 4 characters)	Re-enter password: (Minimum 4 characters)
Company Name:
Address:
Additional address info:
City:	State: Alberta Alaska Alabama Arkansas Arizona British Columbia California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Manitoba Maryland Maine Michigan Minnesota Missouri Mississippi Montana New Brunswick North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nova Scotia Nevada New York Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island South Carolina South Dakota Saskatchewan Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming	Postal Code:
Telephone:
Fax:
Are you your firm's primary representative to MITS? Please indicate below: Primary Firm Representative Additional Firm Participant