ICGIP Corporate Membership

Program Options

Platinum Corporate Membership ($4,395.00)
Gold Corporate Membership ($2,500.00)
Silver Corporate Membership ($1,900.00)

Primary Corporate Contact

Name

Job TItle

Office Phone

Fax Number

COMPANY INFORMATION

Company/Organization Name

Company Address

Please provide a description of your company’s offerings. ICGIP will review for publication use and reserves the right to edit.

Company Description

Certification & Acknowledgement

REFUNDS/CANCELLATIONS:
Program costs are non-refundable.

CERTIFICATION:
I certify that the information submitted in this application is true and correct to the best of my knowledge. I understand that providing false or inaccurate information on this application is grounds for rejection of my application.

I acknowledge that Corporate Membership applications are subject to approval by ICGIP.

I further acknowledge that Corporate Members may not use the ICGIP name or logo without prior written approval from ICGIP.

I have read and agree to the terms above.

Running Total

$4,395.00

Total

$4,395.00

Coupon Code

Billing Information

Name

Credit Card

Visa
Mastercard
American Express
Discover

Address

Phone Number

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