Westchester County Association

Coonections - Membership Application

Becoming a WCA CONNECTIONS member is a simple process:

Complete the application online.
Membership dues are $500 for CONNECTIONS members. Once you join as a CONNECTIONS member you are a member of the WCA.

You can pay your dues on line via credit card or print the application (please click here for printer-friendly PDF form) and mail with your check payable to the Westchester County Association.

You will then be a WCA CONNECTIONS Member! Welcome!

Please fill out the following information describing your organization or business: (Red indicates required information)
Business	Organization
Name of Company/Organization:
Address:

City:
State:	Zip:
Phone:
Fax:
E-mail Address:
	You may publish my email address in the Membership Profile.
	Only use my email address for WCA internal communication.
Web Site Address:
Contact Person:
Number of Employees:
Nature of Organization (Industry Type):
Name of Principal Representative:
Title of Principal Representative:
Additional Representatives:	Organizations may include two additional contacts to receive all WCA & CONNECTIONS information
Contact Name:
Email Address
Contact Name:
Email Address
Description of organization to be printed in Association Membership Profile (50 words or less):

Membership Fees:	Annual Dues for WCA CONNECTION Members is $500 The $50 one-time New Member processing fee, which includes optional email and web site listing in the WCA Online Directory, is waived for CONNECTIONS Members.
All Members of the WCA are listed in our online directory:		Please include my email address and my web site address with my listing in the WCA Online directory.
		Please include only my email address with my listing in the WCA Online directory.
		Please include only my web site address with my listing in the WCA Online directory.

How did you hear about the WCA? Please check one:
	WCA Web Site
	CONNECTIONS mailing
	Newspaper Which one:
	Referral From whom:
	Event Which event:
	Other:

To pay CONNECTIONS membership dues online, please complete the information below or to pay by check, please click here for printer-friendly PDF form (or print this page) and mail with your check for $500 to: Westchester County Association 707 Westchester Avenue White Plains, NY 10604 Attn: CONNECTIONS
Credit Card Payment Information: Visa MasterCard AMEX
Acct #:
Name on Credit Card:
Company Name on Credit Card (if applicable):
Expiration Date:	Month: Year:
Amount Authorized:	$500.00

Name of individual filling out this form:
Phone number:

Westchester County Association - 914-948-6444

The information in this site is believed accurate. However, no guarantee or warranty is made regarding this information. The Westchester County Association, Inc., its members and agents assume no liability for any action arising from use of or reliance upon any information found in or through this web site. Interested parties are advised to independently verify any information herein through personal investigation or with appropriate professionals.