Company *

Point of Contact/Title *

Address *

City *

State *

Zip Code *

Phone *

Fax

Email *

Company Website

Major Service/Product on Schedule

President

President’s Email

CEO

CEO Email

CFO

CFO Email

General Counsel

General Counsel Email

Government Affairs VP/SVP

Government Affairs VP/SVP Email

Other/Title

Other Name

Other Email

Member Committees and Subcommittees (check all that apply) *

Furniture and Furnishings Committee

General / Office Products Committee

Imaging Equipment Committee (topics include MFD and Copiers)

Small Business Committee

GWAC/MAC Committee

Cybersecurity & Supply Chain Committee

IT/Professional Services Committee (topics include IT hardware and Telecommunications)

Healthcare

Medical/Surgical Products Subcommittee

Pharmaceutical Subcommittee

BRIC Committee – Business Regulatory Issues Committee

Green Committee

Membership Tier / Annual Coalition Dues *

Standard Member Small Business (Under $5 million rev.) – $1,750

Standard Member Low ($5 to $15 million rev.) – $3,975

Standard Member High (Over $15 million rev.) – $7,500

Affiliate Member – $6,000 (Law Firm, Association, Consulting Co., or other non-federal contractor)

Premier Member – $10,750

Executive Member – $36,750

Keystone Member – $52,500

Bill to Address *

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Bill to Zip Code *

Authorized Agent *

Submission Date *

Membership Application

Schedule of Annual Dues

Upcoming Events

2024 Small Business Regulatory Year in Review, January 22

IT/Services Committee Meeting with GSA’s Tiffany Hixson, February 4

Healthcare Focus: Briefing on the National Defense Authorization Act (NDAA) for Fiscal Year 2025, February 4