I want to register as an NAIS member and receive the huge benefits and discount package as described for only $3.55 per month. Enclosed is $92.50 ($85.00 signup for two year membership plus $7.50 for insured UPS shipping of membership package) for a two year membership I'm enclosing

{} Check {} Money order or wish to charge my
{} VISA {} Mastercard {} American Express {} Discover

Card Number:_________________________________________ Exp. Date:______

Signature:_________________________________________________________

NOTE: Credit card orders can register by phone at 512-719-3595 or
by fax at 512- 719-3594

Rush My NAIS Membership To:
(Please print clearly: This is for directory insertions and for you to obtain the NAIS mailings) NAME:

NAME:

COMPANY:

ADDRESS:

CITY, STATE, ZIP:

PHONE:

MOBILE:

FAX:

EMAIL:

WEB SITE:

TYPE OF COMPUTER:

SPECIALIZATION:

STATE LICENSE NUMBER

NUMBER OF YEARS IN BUSINESS: