Membership App

LEAP Membership Application Application For Membership – Please type or print Name__________________________Date_______________DOB___________ Address__________________________________________________________ City___________________________State_______________Zip____________ Home Telephone (_____)_____________Email__________________________ Place Of Employment_______________________________________________ Position Held______________________________________________________ Your Firm’s Client Base – Government (___) Commercial (__) Residential (___) Autodesk Software You Use__________________________________________ How many years have you been using Autodesk products?_________________ Have you ever used products that compete with Autodesk such as Bentley?____ If Yes, please specify manufacturer and pertinent releases (i.e. 2009) ________________________________________________________________ Type of membership requested Student - $15 per year – partial year be prorated @ $1.25 per month Individual - $30 per year – Partial year prorated @ $2.50 per month Corporate $150 per year for 1 – 7 employees (New Corporate Memberships prorated @ $12.50 per month) $300 per year for 8 – 15 employees (New Corporate Memberships prorated @ $25 per month) $500 per year for 16 or more employees (New Corporate Memberships prorated @ $41.50 per month)

I have been provided with the bylaws, reviewed them and agree to abide by them Signature________________________________________Date_____________