ISM – Philadelphia, Inc.
Membership Application
Section 1, Member Status
Please check the appropriate box:
□ New Member □ Past Member -- ISM ID Number (if known) ______________________________
□ I am replacing the following member in my company:
Member Name: _____________________________________ ISM ID# __________________________
Recruiting Member: __________________________________ Organization: _______________________________________________
Section 2, Your Information:
Dr. Mr. Mrs. Ms. Miss (Please circle one)
Date of Birth (optional) ____/_____/_____
Name ______________________________________________________________
Title (required)_______________________________________________________
Industry Code (choose a 3-digit code from the list provided on the back of this
application): _____ ____ _____
Organization (required)________________________________________________
Number of employees at your location (please check one):
Please check the preferred mailing address:
□ BUSINESS
□ HOME
□ under 100 □ 100-249 □ 250-499 □ 500-999 □ 1000+
Business: ___________________________________________________
Education (check highest level completed):
___________________________________________________________
□ High school □ Associate's □ Bachelor's □ Master's □ Other
City __________________________State _________Zip ____________
Are you a: C.P.M.□
Business Phone: (_____)___________ Fax: (_____)_________________
E-mail:______________________________________________________
Home: _____________________________________________________
| CPSD □ | CPSM □
Do you hold any other professional designations? □ Yes
list: _________________
□ No If yes, please
City__________________________State_________Zip______________
Are you involved in sales? □ No □ Yes. If so, please
explain________________________________________________
Home Phone: (_____)______-__________ E-mail:___________________
______________________________________________________
Section 3, Membership Type:
District/Affiliate Code: 05/505
There are two membership options. Details on reverse side
ARegular Member dues*:
$ 335.00
Dues include 10 FREE Dinner Meetings with pre-registration required.
Section 4, Method of Dues Payment:
□ Check Check # _____________ Payable to ISM-Philadelphia, Inc.
□ VISA □ MasterCard □ American Express
Pay by:
Or,
Charge Card # __________________________________________________
N
* ote: The annual membership dues are only $300.00, which includes ISM-Philadelphia
and National dues. There is a one-time $35 ISM and ISM-Philadelphia administrative
fee included in the amount above.
Exp. Date: _____/______
AAssociate Member due**:
$ 185.00
Dues include 10 FREE Dinner Meetings with pre-registration required
Does not include National benefits
Cardholder Signature ________________________________
Amount to be charged $____________________
Name on Card __________________________________________________
Return application with payment to: ISM-Philadelphia, Inc., 11 Bala Avenue, Bala
Cynwyd, PA 19004. Fax (267) 244-9218.
**Note: The annual membership dues are only $170.00. There is a one-time $15
administrative fee included in the amount above. You must meet eligibility requirements.
► ISM members receive Inside Supply Management magazine as a $12 portion and ISM InfoEdge as a $12 portion of the membership fee. I agree to abide by the ISM
Bylaws, Principles and Standards of Purchasing Practice, and Statement of Antitrust policy. A copy of the ISM Bylaws may be obtained by calling. ISM’s phone number is
(800) 888-6726. DO NOT MAIL APPLICATION TO ISM. Return application and payment to ISM-Philadelphia, Inc.
Signature_______________________________________________________________________________________ Date __________________
_______________________________________________________________________________________________________
ISM-Philadelphia●11 Bala Avenue, Bala Cynwyd, PA 19004●(215) 878-3389●Fax (267) 244-9218 ●www.ISM-Phila.org
Membership Descriptions
*OPTION I - REGULAR MEMBERSHIP: Regular membership is when an individual chooses to join ISM-Philadelphia, Inc. and ISM-National. ISM-Philadelphia will set
the annual dues for its local membership, which will include ISM dues. Any individual that chooses this type of membership will receive discounts on both ISM and Affiliate
levels.
**OPTION II - ASSOCIATE MEMBER: Associate Membership is available to those persons who meet eligibility standards of ISM-Philadelphia, provided that at least one
other person of the same company division holds a regular (full) membership in the ISM-Philadelphia, Inc. Not more than six Associate Memberships can be available
per company division for each regular member.
•
•
•
Associate Members shall have all benefits and privileges accorded Regular Members except they shall not be permitted to vote or hold office or chair a group
or committee. Because Associate Membership does not include membership in ISM, Associate Members shall pay the same entrance fee and annual dues as
regular members, except for ISM dues.
Associate Members may convert to full membership upon payment of regular membership dues pro-rata. However, no person holding regular (full)
membership will be eligible for conversion to Associate Membership except when he/she is in good standing and at the completion of his/her current paid-up
dues period. No interim refund or dues adjustment will be made.
In any situation involving Associate Members, if the Regular (full) Member of such company organization resigns his/her regular membership, at least one of
the Associate Members of that organization component must convert to regular membership at the beginning of the next dues period.
Dues, contributions, or gifts to this organization are not tax-deductible charitable contributions for income tax purposes. Dues may, however, be
deductible as a business expense.
North American Industry Classification System (NAICS)
Please select the NAICS code that best represents the major activity of your organization. (Write the three-digit code on the reverse side of this form in the appropriate space.)
AGRICULTURE, FORESTRY, FISHING AND HUNTING
RETAIL TRADE
PROFESSIONAL, SCIENTIFIC & TECHNICAL SERVICES
110
Agriculture, Forestry, Fishing & Hunting
440
Retail Trade
541
Professional, Scientific & Technical Services
111
Crop Production
441
Motor Vehicle & Parts Dealers
MANAGEMENT OF COMPANIES AND ENTERPRISES
112
Animal Production
442
Furniture & Home Furnishings Stores
551
Management of Companies & Enterprises
113
Forestry & Logging
443
Electronics & Appliance Stores
ADMIN & SUPPORT & WASTE MGMT & REMEDIATION
114
Fishing, Hunting & Trapping
444
Buildg Matrl & Garden Equip & Supplies Dealers
SERVICES
115
Support Activities for Agriculture & Forestry
445
Good & Beverage Stores
560
Admin & Support & Waste Mgmt & Remediation
MINING, QUARRYING, AND OIL & GAS EXTRACTION
446
Health & Personal Care Stores
Services
210
Mining, Quarrying, and Oil & Gas Extraction
447
Gasoline Stations
561
Administrative & Support Services
211
Oil & Gas Extraction
448
Clothing & Clothing Accessories Stores
562
Waste Management & Remediation Services
212
Mining (except for Oil & Gas)
451
Sporting Goods, Hobby, Book, & Music Stores
EDUCATIONAL SERVICES
213
Support Activities for Mining
452
General Merchandise Stores
611
Education Services
UTILITIES
453
Miscellaneous Store Retailers
221
Utilities
454
Nonstore Retailers
HEALTH CARE AND SOCIAL ASSISTANCE
CONSTRUCTION
TRANSPORTATION AND WAREHOUSING
620
Health Care & Social Assistance
230
Construction
480
Transportation & Warehouse
621
Ambulatory Health Care Services
236
Construction of Buildings
481
Air Transportation
622
Hospitals
237
Heavy & Civil Engineering
482
Rail Transportation
623
Nursing & Residential Care Facilities
Construction
483
Water Transportation
624
Social Assistance
238
Specialty Trade Contractors
484
Truck Transportation
MANUFACTURING
485
Transit & Ground Passenger Transportation
ARTS, ENTERTAINMENT, AND RECREATION
310
Manufacturing
486
Pipeline Transportation
710
Arts, Entertainment & Recreation
311
Food Manufacturing
487
Scenic & Sightseeing Transportation
711
Performing Arts, Spectator Sports & Related
312
Beverage & Tobacco Product Mfg
488
Support Activities
Inds
313
Textile Mills
491
Postal Service
712
Museums, Historical Sites & Similar Institution
314
Textile Product Mills
492
Couriers & Messengers
713
Amusement, Gambling & Recreation Industries
315
Apparel Manufacturing
493
Warehousing & Storage
316
Leather & Allied Product Mfg
INFORMATION
ACCOMMODATION AND FOODS SERVICES
321
Wood Product Manufacturing
510
Information
720
Accommodation & Food Services
322
Paper Manufacturing
511
Publishing Industries (except Internet)
722
Food Services & Drinking Places
323
Printing & Related Support Activities
512
Motion Picture & Sound Recording Industries
324
Petroleum & Coal Products Mfg
515
Broadcasting (except Internet)
OTHER SERVICES (except Public Administration)
325
Chemical Manufacturing
517
Telecommunications
810
Others Services (except Public Administration)
326
Plastics & Rubber Products Mfg
517
Data Processing, Hosting & Related Services
811
Repair & Maintenance
327
Nonmetallic Mineral Product Mfg
519
Other Information Services
812
Personal & Landry Services
321
Primary Metal Manufacturing
FINANCE AND INSURANCE
813
Religious Grant Civic Professional & Similar
332
Fabricated Metal Product Mfg
520
Finance & Insurance
Orgs
333
Machinery Manufacturing
521
Monetary Authorities – Central Bank
814
Private Households
334
Computer & Electronic Product Mfg
522
Credit Intermediation & Related Activities
335
Electric Equip, Appliance, & Component Mfg
523
Securities, Commodity Contracts, & Financial Inv
PUBLIC ADMINISTRATION
336
Transportation Equipment Mfg
524
Insurance Carriers & Related Activities
910
Public Administration
337
Furniture & Related Product Mfg
525
Funds, Trusts, & Other Finance Vehicles
921
Executive, Legislative & General Gov Support
339
Miscellaneous Manufacturing
REAL ESTATE AND RENTAL LEASING
922
Justice, Public Order & Safety Activities
WHOLESALE TRADE
530
Real Estate & Rental & Leasing
923
Admin of Human Resource Programs
420
Wholesale Trade
531
Real Estate
924
Admin of Environmental Quality Programs
423
Merchant Wholesalers, Durable Goods
532
Rental & Leasing Services
925
Admin of Housing Prog Urban Plan &Comm Dev
424
Merchant Wholesales, Nondurable Goods
533
Lessor of Nonfinancial Intangible Assets (except
926
Admin of Economic Programs
425
Wholesale Electronic Markets & Agents &
Copyrighted works)
927
Space Research & Technology
Brokers
928
National Security & International Affairs
_______________________________________________________________________________________________________
ISM-Philadelphia●11 Bala Avenue, Bala Cynwyd, PA 19004 ●(215) 878-3389 ●Fax (267) 244-9218 ●www.ISM-Phila.org