X3T9 DOCUMENT SUBSCRIPTION FORM 1990 This program is designed to improve the distribution of a committee's documents to its members. If you have any questions, please call or write Katrina Gray, Coordinator, Standards Membership Services, 202-626-5741, X3 Secretariat, 311 First St. NW, Suite 500, Washington, DC 20001. Subscriber information to be a member of the Technical Committee(s): 1. Subscriptions are available only to Technical Committee Members (Voting Members, Alternates, Observers, and designated Liaisons.) 2. If you do not check the membership status that applies to you below, you will be added as an Observer. 3. To become a voting member of X3T9 or its subgroups contact the corresponding chair(s). 4. Service fee for membership is $250.00 per committee (X3T9 Voting Members only, may sign up for any X3T9 subgroup and only pay the subscription fee for each additional subgroup selected. No additional service fee will be charged.) NAME (PLEASE PRINT) _______________________________________________ Organization _______________________________________________ Address _______________________________________________ _______________________________________________ _______________________________________________ Telephone ___________________________ I would like to participate as a subscriber on the following committee(s): U.S./Canada Overseas [ ] X3T9 $100.00 $180.00 [ ] X3T9.2 $150.00 $300.00 [ ] X3T9.3 $ 70.00 $140.00 [ ] X3T9.5 $120.00 $240.00 Please check one: [ ] VOTING MEMBER [ ] OBSERVER [ ] ALTERNATE [ ] LIAISON [ ] ADDITIONAL ALTERNATE Subscription fee(s) $____________ Please include my membership fee(s) with this order $____________ TOTAL: $____________ PAYMENT MUST ACCOMPANY ORDER [ ] Check enclosed (make payable to the X3 Secretariat) [ ] American Express # __________________________ EXPIRATION DATE ________ [ ] VISA # ______________________________________ EXPIRATION DATE ________ [ ] MASTER CHARGE # _____________________________ EXPIRATION DATE ________ NOTE: Late subscribers may pro-rate the fees. For subscriptions starting June-August, pro-rate to 75%; September-December, pro-rate to 50%.