Company Name:*Mailing Address: Postal Code:City:State:Phone:*Fax:Country:Web Address: Contact Name:* First Last (i.e. Whom should we contact to finalize this application?)Title:e-mail:*COMPANY KEY INFORMATION (This will be kept confidential and only used in aggregate NetPlus Alliance totals.)Date Founded: Number of Employees:Annual Company Sales:Gross Margin:Total # of Locations:Member of any other buying groups? Yes Please list groups, separated by semi-colon(;)I was referred to NetPlus by:Please email a copy of your line card (pdf, doc or jpg) to: email@example.com We will bill you for the one-time application fee of $1500 when we send your membership materials.