TelecomAssociation 
  
Vendor Directory Listing Form

as of 1/17/2007

To get listed in the TA vendor directory or have your current listing changed, after submitting your vendor membership payment using the TA vendor invoice, simply cut & paste this form and then email it to TA Administrator Kathleen Brown at KB@TelecomAssociation.com. To confirm receipt call 951-296-3870. 

1. Vendor Directory Information - Please provide the following which will be published here in the TA vendor directory:

Full Vendor Company Name:

Agent Contact Person's Full Name:

Contact Person's Full Title:

Contact Person's Full Mailing Address:

Contact Person's Phone Number(s) with extention:

Contact Person's Email Address:

Vendor's Agent Program Landing Page(s):

Summary of Vendor's Agent Program:

Complete (Search Terms) List of Services Agents Can Distribute:

2. Primary Point Of Contact For TA - Who will be TA's primary contact for such things as approval of marketing copy, TA vendor membership renewal, etc.?

Name: 

Title:

Best Phone Number(s):

Email Address(es):

Full Mailing Address(es):

3. Vendor Contacts To Add To TA's Postal & Email Distribution Lists - Please list the full names, titles, phone number(s), email address(es) & postal address(es) of vendor personnel you would like added to TA's email & postal distribution lists so they will see what TA is distributing for you.  

4. Verification - So we can keep on file who has submitted what, please complete the following:

Name __________________________________   Title ____________________________

Phone Number ___________________________  Email ____________________________

Signature (if faxed) _________________________  Date ____________________________

Fax to 951-848-9062 or email to KB@TelecomAssociation.com. Call 951-296-3870 to confirm receipt.

Vendor Program Information Page

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