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2
Date ______/______/______
MI
Last Name
Suffix
Company/Organization
Business Address
Street Address (line 1)
Street Address (line 2)
City
State/Province
Business Phone
Country
Toll-Free Phone
Home Address
Street Address (line 1)
Street Address (line 2)
City
State/Province
Country
Home Phone
Secondary Fax
Primary E-mail
Secondary E-mail
What is your organizations primary business activity (industry)? What category best describes your job function?
Construction
Engineering
Other
(045) Academia
(004) Aerospace
(005) Architecture/Design
(006) Arts/Entertainment/Broadcasting
(046) Automation Systems
(007) Business Mgmt Svcs./Mgmt Consulting
(053) City Management
(008) Computers/Software/DP
(044) Consulting
(009) Defense
(048) E-business
(010) Economics/Finance
(011) Education/Training
(012) Environmental/Waste/Sewage
(041) Engineering
(042) Financial Services
(013) Health/Human/Social Services
(043) Information Technology
(051) International Development
(014) Legal
(015) Printing/Publishing
(016) Public Administration/Government
(017) Real Estate/Insurance
(018) Recreation
(050) Supply Chain
(049) Systems Security
(019) Telecommunications
(020) Transportation
(052) Urban Development
(021) Utilities
(047) Web Technology
(022) Other________________
(157) Chemical
(151) Civil
(152) Electrical
(153) Electronics
(154) Environmental
(155) Industrial
(156) Mechanical
(150) Other____________
(103) Consulting
(106) Distribution
(107) Finance
(127) Financial Services
(110) Legal
(111) Marketing/Business
Resources
(023) Agriculture
(027) Coal/Gas/Oil
(025) Ferrous Mining
(024) Forestry
(026) Non-Ferrous Mining
Manufacturing
(028) Automotive
(029) Chemical
(030) Concrete/Clay/Glass/Stone
(031) Electrical/Electronic
(032) Food
(033) Machinery/Metals
(034) Paper
(035) Petroleum
(040) Pharmaceutical
(036) Plastics
(037) Textiles/Fabrics
(038) Wood
(039) Other________________
Management
(102) Communications
(149) Configuration
(104) Contract/Procurement
(101) Corporate/Administrative
(105) Cost
(148) Critical Chain
(147) Earned Value
(108) Human Resources
(109) Information/Computer
(112) Materials
(114) Project/Program
(117) Quality
(118) Records
(120) Risk/Safety
(121) Scope/Technical
(122) Site/Facility
(124) Time Mgmt/Scheduling/Planning
Development/Sales
(113) Production
(115) Project Accounting/Audit
(116) Public Relations
(119) Research/Product Development
(128) Service & Outsourcing
(123) Teaching/Training
(146) Web Strategist/Technologist
(125) Other___________________
__________________________
$119.00
$10.00
____________________________________
$___.__
$_____.__
__________________________________________________________
OPTION 2 PMI Student Membership
15 or fewer
16 - 99
1,000 - 2,499 2,500 - 4,999
100 - 499
500 - 999
5,000 or more
$10.00*
$10.00
PMI Directories
PMI Announcements
Home
Business
Home
Business
Home
Business
Fax
$___.__
$_____.__
METHOD OF PAYMENT:
VISA
MasterCard
American Express
Diners Club
For more information on specific PMI Components, visit the PMI web site at www.pmi.org. To
obtain a faxed list of the contact information for PMI Components, call PMIs Fax on Demand Service
at: 800-495-5201 in the U.S. and Canada or +303-454-3333 for all other locations.
NORTH CAROLINA
Metrolina (Charlotte, NC) ................................... 20.00
N. Carolina Piedmont Triad ................................. 15.00
North Carolina ..................................................... 20.00
OHIO
Central Ohio (Columbus) .................................... 25.00
Dayton/Miami Valley, Ohio ................................. 20.00
Northeast Ohio .................................................... 20.00
Northwest Ohio ................................................... 15.00
Southwest Ohio ................................................... 20.00
ARIZONA
Phoenix, AZ ......................................................... 20.00
Tucson, AZ .......................................................... 20.00
ARKANSAS
Central Arkansas ................................................. 15.00
CALIFORNIA
Los Angeles, CA ................................................. 25.00
Los Padres .......................................................... 25.00
Orange County, CA ............................................. 35.00
Sacramento, CA .................................................. 20.00
San Diego, CA ..................................................... 25.00
San Francisco Bay Area ...................................... 25.00
Silicon Valley, CA ............................................... 25.00
Wine Country, CA ............................................... 25.00
COLORADO
Mile-Hi, Denver .................................................. 20.00
Pikes Peak Regional, CO .................................... 20.00
KANSAS
KC Mid-America ................................................. 20.00
Wichita ................................................................ 20.00
CONNECTICUT
Southern New England ........................................ 20.00
MASSACHUSETTS
Mass Bay (Boston) .............................................. 20.00
DISTRICT OF COLUMBIA
Washington, DC .................................................. 25.00
MICHIGAN
Great Lakes (Detroit) ........................................... 20.00
Michigan Capital Area ......................................... 20.00
Michigan Thumb ................................................. 20.00
Western Michigan ............................................... 20.00
FLORIDA
Central Florida .................................................... 20.00
Northeast Florida ................................................ 20.00
South Florida ...................................................... 20.00
Suncoast, FL ....................................................... 20.00
Tampa Bay, FL ..................................................... 25.00
GEORGIA
Coastal Empire .................................................... 15.00
Columbus, GA ..................................................... 15.00
Georgia (Atlanta) ................................................. 20.00
Savannah River ................................................... 20.00
KENTUCKY
Kentuckiana (Louisville) ..................................... 20.00
Kentucky Bluegrass ............................................. 20.00
PENNSYLVANIA
Delaware Valley ................................................... 20.00
Keystone, PA ....................................................... 20.00
Pittsburgh, PA ..................................................... 15.00
PUERTO RICO
San Juan, Puerto Rico ......................................... 40.00
MAINE
Maine .................................................................. 20.00
SOUTH CAROLINA
Charleston, SC .................................................... 20.00
Palmetto (Greenville, SC) ................................... 25.00
South Carolina Midlands .................................... 20.00
MARYLAND
Baltimore, MD ..................................................... 15.00
Southern Maryland ............................................. 20.00
MINNESOTA
Minnesota ........................................................... 20.00
MISSOURI
Metropolitan St. Louis ........................................ 25.00
Mid-Missouri ...................................................... 20.00
NEBRASKA
Heartland-Omaha ................................................ 20.00
NEVADA
Southern Nevada ................................................. 20.00
IDAHO
Eastern Idaho ...................................................... 20.00
Western Idaho ..................................................... 20.00
NEW JERSEY
New Jersey .......................................................... 20.00
INDIANA
Central Indiana .................................................... 20.00
OREGON
Portland .............................................................. 20.00
Williamette Valley, OR ......................................... 20.00
LOUISIANA
Baton Rouge, LA ................................................. 20.00
Greater New Orleans, LA ..................................... 20.00
Northwest Louisiana ........................................... 20.00
SW Louisiana/SE Texas ...................................... 20.00
HAWAII
Honolulu ............................................................. 20.00
ILLINOIS
Central Illinois (Bloomington) ............................ 20.00
Midwest, IL/WI (Chicago) ................................... 30.00
OKLAHOMA
Green Country (Tulsa) ......................................... 20.00
Red Earth ............................................................. 25.00
NEW MEXICO
Otowi Bridge (Los Alamos, NM) ......................... 15.00
Rio Grande, New Mexico .................................... 15.00
NEW YORK
Binghamton, NY .................................................. 20.00
Buffalo, NY .......................................................... 20.00
RHODE ISLAND
Ocean State ......................................................... 20.00
TENNESSEE
East Tennessee .................................................... 20.00
Memphis, TN ...................................................... 25.00
Nashville, TN ....................................................... 20.00
TEXAS
Alamo, TX ........................................................... 20.00
Amarillo, TX ........................................................ 25.00
Austin, TX ........................................................... 20.00
Dallas, TX ............................................................ 20.00
Fort Worth, TX ..................................................... 20.00
Houston, TX ........................................................ 20.00
UTAH
Northern Utah ...................................................... 20.00
VERMONT
Champlain Valley, VT .......................................... 20.00
VIRGINIA
Central Virginia ................................................... 20.00
Hampton Roads ................................................... 15.00
WASHINGTON
Puget Sound ....................................................... 30.00
Tri-Cities/Columbia Basin .................................. 20.00
WEST VIRGINIA
TriState, WV ........................................................ 20.00
WISCONSIN
Madison/S. Central, WI ...................................... 20.00
Milwaukee/Southeast Wisconsin ........................ 20.00
5
ARGENTINA
Buenos Aires ..................................................... $55.00
IRELAND
Lambay, Ireland ................................................... 40.00
AUSTRALIA
Melbourne, Australia ........................................... 40.00
Queensland ......................................................... 40.00
Sydney, Australia ................................................ 40.00
ISRAEL
Israel ................................................................... 30.00
ITALY
Northern Italy ...................................................... 10.00
Rome, Italy .......................................................... 45.00
AUSTRIA
Vienna, Austria .................................................... 20.00
BELGIUM
Benelux ............................................................... 30.00
BRAZIL
Minas Gerais, Brazil ............................................ 20.00
Rio de Janeiro, Brazil .......................................... 20.00
Sao Paulo, Brazil ................................................. 20.00
CANADA
Fort McMurray .................................................... 15.00
Lakeshore ............................................................ 20.00
Levis, Quebec ...................................................... 20.00
Manitoba, Canada ............................................... 25.00
Montreal .............................................................. 30.00
New Brunswick .................................................... 20.00
North Saskatchewan ............................................ 20.00
Northern Alberta .................................................. 20.00
Nova Scotia ......................................................... 20.00
Ottawa Valley/Outaouais ..................................... 20.00
Regina/S. Saskatchewan ..................................... 20.00
Southern Alberta ................................................. 20.00
Southern Ontario ................................................. 20.00
Thames Valley District ........................................ 20.00
Vancouver Island ................................................. 20.00
West Coast, BC ................................................... 20.00
CHILE
Santiago, Chile ................................................... 50.00
CHINA
Hong Kong, SAR, China ..................................... 25.00
COLOMBIA
Santafe de Bogota ............................................... 30.00
JAMAICA
Doctor Bird .......................................................... 50.00
JAPAN
Tokyo ................................................................... 50.00
MALAYSIA
Malaysia .............................................................. 20.00
MEXICO
Mexico ................................................................ 30.00
Monterrey, Mexico .............................................. 20.00
DENMARK
Copenhagen ........................................................ 30.00
EGYPT
MENA .................................................................. 20.00
SWEDEN
Central Sweden ................................................... 25.00
FRANCE
Hauts-de-France ................................................. 30.00
France ................................................................. 30.00
France SUD ......................................................... 30.00
TAIWAN
Taipei, Taiwan ...................................................... 30.00
GERMANY
Frankfurt, Germany ............................................. 20.00
Munich, Germany ............................................... 20.00
INDIA
Bangalore, India .................................................. 12.00
UNITED KINGDOM
United Kingdom .................................................. 30.00
INDONESIA
Jakarta, Indonesia ............................................... 15.00
VENEZUELA
Venezuela ............................................................ 30.00 College of Performance Management ................. 15.00
PMI COLLEGE
To apply for the PMI Group Billing Plan, please complete and return the form on
the following page and enclose one individual membership application for each new
member along with payment. Photocopy the application as needed. Applications are not
required for renewing members.
For More Information
Date ______/______/______
Organization Information
Company/Organization
Street Address (line 1)
Street Address (line 2)
City
State/Province
Phone
Fax
Country
Web Page Address
Organization Contact
Prefix (Mr., Mrs., Ms., Dr.)
First Name
MI
Last Name
Suffix
Job Title
Phone
Fax
E-Mail Address
List a minimum of 15 individuals below who will become members under your organizations group plan. Attach one completed Individual Membership Application for each new member submitted (make photocopies as needed.) The 15 individuals may be all new members, all renewing members, or a combination of new and renewing
members. Please send payment (Box C.) now for those individuals under your group plan who are new members or individuals whose membership will be up for renewal within 3
months from date of this application. For all other renewals, your organization and the renewing members will receive invoices upon their individual membership expiration dates.
Application
Enclosed
1. ____________________________________________________________________
2. ____________________________________________________________________
3. ____________________________________________________________________
4. ____________________________________________________________________
5. ____________________________________________________________________
6. ____________________________________________________________________
7. ____________________________________________________________________
8. ____________________________________________________________________
9. ____________________________________________________________________
10. ___________________________________________________________________
11. ___________________________________________________________________
12. ___________________________________________________________________
13. ___________________________________________________________________
14. ___________________________________________________________________
15. ___________________________________________________________________
16. ___________________________________________________________________
17. ___________________________________________________________________
18. ___________________________________________________________________
19. ___________________________________________________________________
20. ___________________________________________________________________
C. DUES INFORMATION: One full year membership per individual. Membership dues for PMI and Components selected. To participate each participant must
METHOD OF PAYMENT: Payment enclosed Payments must be in
the form of a check or money order in U.S. dollars, drawn on a U.S. bank.
Or you can use one of the following credit cards.
VISA MasterCard American Express Diners Club
$_______.__
$_______.__
Overseas Air Mail (Outside North America ____x $60.00 per individual $_______.__
application)
TOTAL ENCLOSED
$_______.__
select at least one Chapter and one SIG. (For a list of PMIs currently chartered Components and their fees, see pages 5-6 of this form.)