New England Fiberoptic Council

Please complete this form and mail with fee to:

NEW ENGLAND
FIBEROPTIC COUNCIL
P.O. BOX 67228
CHESTNUT HILL, MA 02467
TEL (617) 548-NEFC
Fax (617) 507-6397

Name________________________________________________________

Title__________________________________________________________

Company _____________________________________________________

Address______________________________________________________

City__________________________________________________________

State _________________  Zip___________________________________

TEL__________________________________________________________

FAX__________________________________________________________

E-Mail________________________________________________________

Web _________________________________________________________

___ Individual            ___ Corporate

Membership fees are:

Individual: $35

Corporate: --
Sales < $499K: $100
Sales $500K – $1.9M: $250
Sales $2M – $10M: $500
Sales > $10M: $1000

(membership fee must be included with this form)

Please mail check to:
NEFC
P.O. BOX 67228
CHESTNUT HILL, MA 02467