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RETURN TO: Kevin Hunt ITS PA Membership Chair Gannett Fleming 1515 Market Street, Suite 2020

FOR INTERNAL USE Date received: Contact information added to data base Interest forwarded to committees (if applicable) Confirmation sent to contacts Dues received (if applicable) Confirmed ITSA “Designated State Chapter” status (if applicable) Dues sent to treasurer (if applicable).

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RETURN TO: Kevin Hunt ITS PA Membership Chair Gannett Fleming 1515 Market Street, Suite 2020

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  1. FOR INTERNAL USE • Date received: • Contact information added to data base • Interest forwarded to committees (if applicable) • Confirmation sent to contacts • Dues received (if applicable) • Confirmed ITSA “Designated State Chapter” status (if applicable) • Dues sent to treasurer (if applicable) 2013 MEMBERSHIP FORM Thanks for your interest in the Intelligent Transportation Society of Pennsylvania. To better serve our members, our membership classes include Organizational, Affiliate and Student member. Please decide what class best serves your needs and complete the form below. If you have any questions or comments please contact the Membership Chair or log ontowww.itspennsylvania.comfor more details. Organizational Membership - Organizational membership shall be open to companies, corporations, associations, governmental agencies, academic organizations and other organizations interested in advancing the purposes of the Chapter. All Organizational members shall have the same rights, privileges, duties, and obligations. Organizational members shall have 2 votes in all matters to be voted on by the members. Affiliate Membership -Affiliate memberships shall be open to any individual interested in advancing the purposes of the Chapter if the individual’s employer is not an Organizational member of the Chapter or if the individual has no employer eligible for membership. Affiliate members shall have 1 vote in all matters to be voted on by the members. Affiliate Memberships are not available to members of organizations with greater than 50 employees. Student Membership - Student membership is open to full-time university or college students who are interested in advancing the purposes of the Chapter. Student members shall not have voting rights. RETURN TO: Kevin Hunt ITS PA Membership Chair Gannett Fleming 1515 Market Street, Suite 2020 Philadelphia, PA 19102-1917 Phone: 215.557.0106 x 1528 Fax: 215.557.0337 E-mail: khunt@gfnet.com • HOW DID YOU HEAR ABOUT ITSPA • Past Member • Colleague • Newsletter • Facebook • Twitter • LinkedIn • Other * All members should provide contact information on the attached page. Please process the above chapter membership. Below is my signed authorization. SignatureDate Printed Name

  2. Organizational members please attach additional secondary contacts

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