CONTACT
INFORMATION:
Company Name:
Parent Company, if applicable:
Principal Contact's Full Name :
Title:
Street Address:
Address (cont.):
City:
State/Province:
Zip/Postal Code:
Country:
Work Phone:
FAX:
E-mail:
Company's Internet Address:
# of Field Offices:
# of Employees:
Alternate Contact's Full Name:
Title:
Street Address:
Address (cont.):
City:
State/Province:
Zip/ Postal Code:
Country:
Work Phone:
FAX:
E-mail:
How or from whom did you hear about PSC?
CLASSIFICATION:
Please check all appropriate North American Industrial Classification System (NAICS)
Codes below
Professional, Scientific, and Technical
Services
54121 Offices of Certified Public Accountants
54161 Management Consulting Services
54131 Architectural Services
54169 Other Scientific and Technical Consulting
54133 Engineering Services
54171 Research and Development in the Physical Sciences and Engineering Services
54136 Geophyscial Surveying and Mapping Services
5417 Research and Development in the Life Sciences
54137 Surveying and Mapping Services (except Geophysical Services)
54173 Research and Development in the Social Sciences and Humanities
54138 Testing Laboratories
54191 Marketing Research and Public Opinion Polling
54142 Industrial Design Services
54169 Other
(please specify)
54151 Computer Systems Design and Related Services
FINANCIAL INFORMATION:
This information will only
be used for membership management and the
generation of aggregated industry
statistics
Please note gross annual receipts from the
following during your most recent fiscal
year:
Federal Government
$
Commercial
$
International
$
State/Local Government
$
Other
$
TOTAL (Line A)
$
Dues Formula
Amount of Gross Annual Receipts
Less than $2.8 million
$2.8 million to $58.8 million*
$58.9 million to $100 million
$101 million to $300 million
$301 million to $500 million
$501 million to $1 billion
$1 billion to $4 billion
Greater than $4 billion
Amount of Dues
$750
(gross annual receipts in millions) x( $270)*
$18,700
$23,700
$27,200
$31,000
$33,000
$35,000
*Calculation
of Dues: (________________) X
($270) = ___________________
Gross
Annual Receipts
Amount of
Dues
(Line A in millions)
Please enter your Total Gross Annual Receipts:
$
Million
Total REGULAR dues amount:
$
Dues cover one year of membership in PSC. The date your application
is received in your initial year of joining is your renewal date for invoicing in subsequent years.
New member applications are subject to approval by the Board of Directors.
Dues paid to PSC are not deductible as charitable
contributions. However, for calendar year
2006 PSC's dues are
• 96% allowable for inclusion in the indirect rates of government contractors and
• 89% may be deductible for federal income tax purposes. (According
to IRS regulations, the portion of dues allocable to lobbying
activity is not tax deductible. PSC estimates that
11% of
your dues is allocable to lobbying activities and, therefore,
not deductible.)
Payment Procedure: PSC will invoice you once your application
is received.