Membership Form
Home Join LISH Programs Free Posters Updates Contact us ----MEMBERS---- New Laws Bulletins & Posters   Defensive Management Safety Auto Report Construction Food & Beverage Retail Tax Transportation Library   back to:	Membership Form (please fill out the form as accurately as possible, we will contact you by either e-mail or phone) *Name: Company: Address: *Phone: City: Fax: State: E-mail: Zip Code: *No. of employees: Choose One ----------------- Up to 50 employees Over 50 employees Best time to contact: Choose One ----------------- Early Morning Day Evening *GE Tax License#: **Payment method: Check Credit card **We will confirm your membership form by either phone or e-mail and instruct you where you can send payment if paying by check or take your credit card information over the phone. Membership fee is $175 [up to 50 employees] or $300 [over 50 employees] in annual dues. *Denotes a required field
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