Associate Members Profile

Company Name:

Name of Contact Person:

Position:

Address:

City:

State/CD:

Zip:

Country Name:

Work Phone:

Toll Free:

Fax Phone:

Email:

Website:

Chapter Affiliation(s):

2008 Associate Membership Dues ______x $45.00

I will be paying by:

Total Dues:

CHECKS PAYABLE TO APTA
Please send to:
Paul Swart, Director of Corporate Membership
2041 N.W. West Hills Avenue
Bend, OR 97701 USA

WIRE TRANSFERS: (Please add $25.00 to your payment for bank fees)
Bank:
The Suffolk County National Bank
74 Echo Avenue
Miller Place, New York 11764
Phone: 631-474-8400
Account: Association for the Promotion of Tourism to Africa.
Account: # 1320011347
Routing: # 21405464

Thank you for your prompt payment!