Society of Professional Consultants

On-Line SPC Membership Application

Directions:

When you have completed the form, click the "Submit" button to send your information to our administrative office for procesing. Tthe "Reset" button will clear the entire form and allow you to start over. You can use the TAB key to move between fields. Do not use the Enter key as this will send an incomplete form.
After you complete this form you will be directed to a page with another short form to fill in your name, preferred user name and password to allow access to the Members Only section of the website. You will be notified by e-mail when this is active.
IMPORTANT:
Please complete the entire Membership Application Form. This information will be used by the Referral Program Chair to match you with inquiries for consulting assistance. You can always make changes later. We have a special Profile Update page in the password protected section of the SPC Web site.

Note:

Your membership will take effect when we receive either notification of a completed transaction from PayPal or a check in the amount of $150.00 payable to SPC. Mail your check to:

The Society of Professional Consultants
P.O. Box 67192
Chestnut Hill, MA 02467

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Fields marked with * are required.

* I have read and accept the SPC Standards of Conduct I accept
(Use the browser's back button to read this document.)

* To make payment,
I will mail a check I will use a credit card

* Do you want to be listed in the Referral Section of the SPC Web site?
Yes No
If you choose Yes to be listed on the SPC Web site, only the fields with teal labels will be included in your listing.

As you continue, please use the TAB key to move between fields.
Do not use the Enter key or you will send an incomplete form.).

Name and Company

* First Name:
Middle Name:
* Last Name:
Company Name:
Title:

Contact Information

Street:
City:
State:		ZIP:
* Business Telephone:		Ext:
Home Telephone:
FAX:
* E-Mail Address:
Web Site URL:

What is your company status?
Self-Employed	Small Business	Corporate Employee	Other

Total Number of Employees in Your Company:
Sole Proprietor	2 to 4	5 to 10	Over 10

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Functions you perform: (Be specific, and check all that apply. These are used to search our referral service database.)
Business Management	Computer Technical Support	Computer Networking
Consumer Products & Services	Disaster Recovery	Engineering
Executive Coaching	Financial Management	Graphic Design & Illustration
Human Resources	Information Technology	Internet Applications
International Commerce	Market Research	Marketing Communications
Marketing Strategy	Meeting Planning	Organizational Development
Product Development	Project Management	Public Relations
Quality Assurance	Research & Development	Sales
Software Applications	Strategic Planning	Technical Writing & Manuals
Training, Computer	Training, Internet	Training, Personal Development
Training, Sales	Web Site Design
Other:

Do you prefer working with (check all that apply):

Companies up to 50 employees.	Companies over 50 employees.	Fortune 1000 companies.
Any size company	Non-profit organizations	Individuals
Start-ups	Other:

SPC is a volunteer organization. Would you like to assist in any of the following areas:

Workshops and Seminars	Membership	Mentoring
Monthly Meeting Planning	Referral Service	Marketing
		Public Relations

Other:

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SPC makes timely updates to the membership database available for members' use only. Do you prefer:

Copy of the Access database file electronically.	Printed sheets by mail.
NOTE: This is available on the Members Only section of the web site

Our Referral Service uses the following information to help match you with prospective clients. Please be specific, otherwise matching your expertise correctly with inquiries for a consultant will be difficult.

Provide a 50 word, or less, description of your practice and the specific industries you serve. (This will be used on the SPC Web site profile page, if you have checked the box requesting this listing.) Descriptions which are too long will be truncated.
Note: The single word search will find a word in this section. If there is a specific word you would like your name to be listed under, like a job function that does not appear above, include that word here.

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Identify 3 or 4 typical projects:

List your services and/or products:

Provide a 50-word or less biography of your professional history.

How did you hear about SPC?
(friend, Web site, newspaper listing?)

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The Society of Professional Consultants, Inc. prohibits discrimination based on race, religion, age, sex, sexual preference, creed, or disability.

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