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Fax:

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Web site:

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Please list the trade names and address under which your organization operates.

Please list your organization's primary functions:

During the past seven years, including as of the date of this application, has your organization, subsidiary, or any of its principals been the subject of a federal, state or regulatory order or judgment, whether by consent or otherwise? If yes, please explain and forward copies to the above address.

Please determine and check your membership category and dues level. If your application is approved, we will contact you to make billing arrangements.

I confirm that all the information included in this application is accurate.

Applicant Name:

* Membership services and benefits begin with approval of application by the Alliance Steering Committee and receipt of dues. ALL NEW MEMBERS ARE SUBJECT TO REVIEW AND APPROVAL BY THE ALLIANCE STEERING COMMITTEE. MEMBERSHIPS ARE FOR A ONE-YEAR PERIOD AND MUST BE RENEWED ANNUALLY. RENEWAL APPLICATIONS ARE SUBJECT TO STEERING COMMITTEE APPROVAL.

As an Alliance Against Fraud in Telemarketing & Electronic Commerce Member, my organization can provide: