Plan Room Membership Request Form
Complete the following Form and Submit. All fields marked with a are required.

Step 1 of 2

Contact Information
First & Last Name
Title
Company
Mailing Address
Address
City, State & Zip	,
Shipping Address
Address
City, State & Zip	,
Internet
E-Mail
Web URL
Phone Numbers
Primary
Mobile
Fax
Alt. Phone
Select all categories related to your company
Architect
Contractor
Electrical
Engineer
Mechanical
Owner
Supplier
Other Information
Select your preferred  notification method	E-Mail Fax US Postal Mail
Primary Internet  Connection	Dial-Up DSL/Cable Other
Comments
Acknowledgement		I acknowledge a Topeka Plan Room membership requires a $300 annual membership fee for the fiscal year of July 1st, 2005 until June 30th, 2006. Payment is required within 30 days. Access to Plan Room will not be available until payment is received. Partial year memberships will be prorated at $25 per month.