Strategic Partners Application Form

CEG Strategic Partners Application

Once you have been recommended to apply as a Strategic Partner, complete the application form below...

    Strategic Partnership Application

    General Information — all fields marked * are required

    Basic Information

    Date

    Business Name *

    Principal First Name *

    Principal Last Name *

    Business Address, City, State & Zipcode *

    Contact Details

    Your Email Address *

    Mobile Telephone Number *

    Office Telephone Number

    Fax Number

    Website URL *

    Company Details

    Year Founded *

    Legal Structure *

    Date of Incorporation

    Number of Years in Business *

    Years at Present Location *

    Total Full-Time Staff *

    Total Part-Time Staff

    About Your Company

    Provide a short description of your company *

    Summarize the nature of your business and why you want to become a Strategic Partner *

    As a Strategic Partner, what savings, discounts or benefit incentives would your company offer to CEG members? *

    Strategic Partner Commitments

    1. Pay a yearly membership fee (choose one — fees not due until board approval)

    $100 Small company — annual sales under $500K

    $200 Medium company — annual sales $500K to $1M

    $300 Large company — annual sales over $1M

    $1,000 Major corporation

    2. Document CEG member benefits

    Track and report CEG member sales and incentives

    3. Support CEG events

    Attend and participate in CEG meetings and events

    Declaration & Authorization

    I hereby certify that my answers to the questions appearing in this Strategic Partnership Application: General Information form are true and complete.

    *SUBMIT your signature electronically by selecting the "I Accept" button and typing your first and last name and date in the spaces provided below. This is your agreement that your electronic signature is the legal equivalent of your manual signature on this declaration and authorization page, and your consent to be legally bound by it.

    I hereby certify that my answers are true and complete

    I ACCEPT — electronic signature

    My electronic signature and today's date

    Full Name (electronic signature) *

    Date *