Research Valley Technology Alliance

*Note: All fields marked with an asterisk (*) are required.

*Name of Firm
*Began Operations
*Contact
*Title
*Address
*Phone
*Fax
*E-Mail
*Web URL

*Others Members
*Affiliations
*Type of Business

Products Manufactured or Type of Service:

*Products

*Services

Number of Employees:

*Full Time
*Part Time
*Type of Skills Employed (core competencies such as Programming, Assembly, Electrical Engineering)
Approximate Total Annual Sales (local office)

<$500k

$500k-$1M

$1M-$2M

>$2M

*Government Agencies With Whom You Contract
*What Are Your Target Industries

Membership Dues	Please Send Dues To:
$75.00 Company Membership Dues $40.00 Non-profit Membership Dues � (includes TAMU System entities) $150.00 Affiliate* Membership Dues �� *Affiliate member is a non-technology related company	Research Valley Technology Alliance P.O. Box 9746 College Station, TX 77842-9746

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