While you may submit this application electronically, you will not be activated until your
payment is received. Please make checks payable to:

INNOVATION VALLEY TECHNOLOGY COUNCIL
1020 Commerce Park Drive • Oak Ridge, Tennessee 37830

We also accept Visa, Mastercard and American Express. Upon submission of this form, a confirmation
page will be displayed. From there, you can choose to complete other forms or continue to check-out.

New Application Update Information
Company:
Address:
City, State, Zip:
Telephone:
Fax:
Contact Name:
Title:
Address:
(if different)
E-mail:
Web Site:
Recruited By:
Brief Description of Your Company


Please check all categories that apply.



BUSINESS SERVICES:TECHNOLOGY COMPANIES:
  
Accounting/Banking/Financial Services Biomedical
Architects/Construction/Real Estate Computer Security Services
Audio/Video/Multimedia Computer Training & Educational Institutions
Community Development Organizations Graphic Art & Design/CAD/CAM
Legal Services Hardware & Software Vendors
Management Consulting/Services Manufacturing/Productions
Marketing and Public Relations Network Design & Development
Publishing/Printing Research Laboratory
Staffing Software Design & Development
Systems Integration
Telecoms/ISPs/Web Design & Hosting
Other


Select one   Number
of Employees		   Category   Annual
Dues 		  Representatives
  >100   Large   $750   3
  10-100   Medium   $375   2
  1-9   Small   $150   1


Members of these area chambers receive a $50 discount on their dues. Please check the box if you are a member of one of the following Chambers:
  • Knoxville Area Chamber Partnership
  • Oak Ridge Chamber of Commerce
  • Blount County Chamber of Commerce