P.O. Box 350
Gladwyne, PA 19035
PROPOSAL FOR MEMBERSHIP FORM
ONLY ACTIVE INTELLENET MEMBERS MAY USE THIS FORM.
Other inquiries should be emailed to email@example.com.
Recommending Member: _________________________ Date:__________________
Recommending Member Email Address: ____________________________________
Telephone: ___________________________ Fax:____________________________
Name: _______________________________ Title: _________________________
Company_____________________________ Location: _________________________
Telephone____________________________ Fax: _____________________________
How Known (Personal, Business, Both, Other)?_________________________________
How Long Known? ______________
Does Recommended Party meet all INTELLENET
Requirements (See By-Laws and
Code of Ethics)?
Please provide a brief narrative explaining the following:
Has the Candidate expressed a desire to be a member of INTELLENET? If the proposed member is
located in an area where we have coverage, why would that member be an asset to INTELLENET?
Are there any other factors you would like to mention? (i.e. Expertise, Specialties,
Special Connections or knowledge).
Submit the completed form to the Executive Director by: E-mail to firstname.lastname@example.org or MAIL to INTELLENET , PO Box 350, Gladwyne, PA 19035