Colonial Total Rewards Association

1. Colonial Total Rewards Association CTRA Colonial Total Rewards Association Membership Application Serving Central Connecticut andWestern Massachusetts since 2012 Applicant Information Applicant Name _______________________________________________ Company Name _______________________________________________ Title _______________________________________________ Address _______________________________________________ City, State, Zip Code _______________________________________________ Email _______________________________________________ Telephone __________________ Ext. _____ Fax _______________ Certifications [ ] CCP [ ] GRP [ ] CBP [ ] CSCP [ ] CECP (check all that apply) [ ] WLCP [ ] CEBS [ ] Other _____________________ How did you hear about CTRA? ______________________________________ Membership Fees Membership fees are based on the calendar year: [ ] $100 – 2013 Regular Membership [ ] $50 – 2013 Student Membership To be eligible for the Student Membership rate, you must be enrolled at a college or university as a full-time undergraduate (12 or more credits) or graduate student (9 or more credits) and must not be working on a full-time basis in an exempt Human Resources position. Please mail your check, proof of student status and this completed Membership Application to receive the Student Membership rate.

2. Colonial Total Rewards Association CTRA Colonial Total Rewards Association Membership Application Serving Central Connecticut andWestern Massachusetts since 2012 Membership Profile Indicate total number of employees in your organization. Include full-time employees and full-time equivalents as well as bargaining units and all controlled subsidiaries. [ ] 1-100 [ ] 101-250 [ ] 251-500 [ ] 501-1000 [ ] 1000+ What is your area of specialization? (check all that apply) [ ] Base Pay [ ] Variable Pay [ ] Executive Compensation [ ] Stock Option Administration [ ] Sales Compensation [ ] International [ ] Other (please specify) ___________________________ What topics would you like to see addressed at future meetings? __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Thank you for your membership in CTRA. Please mail this completed Membership Application and check payable to Colonial Total Rewards Association to: Colonial Total Rewards Association c/o CBIA – Phillip Montgomery 350 Church St. Hartford, CT 06103-1126