WESO Membership Application

Today’s Date: Membership Year: Oct 1 to Sep 30

First Name:
Last Name:
Company Name:
Title:
Mailing Address:
City:	State: Zip:
Business Phone:
Fax:
Cell Phone:
E-Mail:
Web Site:

Home Address:	City: Zip:
Home Phone:
Include my business information on the WESO website (public area):
Business Description (approx. 40 word max.)

Do you offer a discount on your products/services to WESO members?
Describe Discount:
How did you decide to join WESO? (Please check one below and explain.)
Current WESO member referred/encouraged me. Member's name:
Other. Explanation:

<<Click submit button to send form and pay online with Credit Card or PayPal.

If you would like to apply via mail, simply enter your information in the form, print the page, and mail with a check payable to:

WESO
P. O. Box 1662
Medford OR 97501

Print page for mailing

(NOTE: Your information is not sold or distributed outside the WESO membership without your permission.)

WESO USE ONLY
Amt Rec’d: ___ Entered in database ___ Entered in member email list ___
Entered in main email list ___ Entered on website___ Emailed info to new member ___