Join WEB – Worldwide Employee Benefits Network

Membership Application Form

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Contact Information

First Name:

Middle Name:

Last Name:

Title: (use N/A if in between jobs)

Company: (use N/A if in between jobs)

Business Address

Address 1: *

City: *

State: *

Zip: *

Telephone: * (Please use dots (.) when entering phone numbers, e.g. 555.555.5555)

Fax: (Please use dots (.) when entering phone numbers, e.g. 555.555.5555)

Email: *

Check here if you do not want the above business information to be listed in the online membership directory.

Home Address

In the event you forget to contact WEB when your work address or work email address change, your home address will enable WEB to keep in contact with you. Please fill in your home information below; it will not be part of the online membership directory.

Address 1: *

City: *

State: *

Zip: *

Telephone: * (Please use dots (.) when entering phone numbers, e.g. 555.555.5555)

Email: *

Professional Information

Fill in as much information as possible about your work to help people find you in the online directory.

Number of Employees in Company: *

Estimated Co. Annual Revenue:

Number of Years in Profession: *

Professional Designation/Certifications:

Actuarial

Attorney

CPA

CEBS

SPHR/PHR

Other: (Separate with commas)

Position within Company

If "other", please specify

Business or Industry: *

Insurance Broker/Consultant

Plan Sponsor:

Service Provider:

Government

Other:

Industry Area *

Retirement

Health & Welfare

Flexible Benefits

Other

WEB Membership Selection

All new WEB memberships, with the exception of the Two-Year Membership, cover a 12-month period.

During a membership campaign, extra months are offered for the same price as a 12-month membership.

Note: WEB dues are usually deductible as a business expense. Check with your tax advisor to determine the tax deduction that may apply to your particular circumstance.

Membership Type: *

Individual Membership ($200) Two-Year Individual Membership ($350) Save $25.00! Government Membership ($125) Associate Membership* ($95) Online Membership — Limited Access ($100)

* Associate level membership is available to retirees, full-time students and benefits professionals who are unemployed or on unpaid leave.

* Individual Online Members of WEB enjoy all the regular benefits of WEB Membership, but are not affiliated with any local WEB Chapter. Individual Online Members may attend local Chapter Events, but must pay the non-member rate. Individual Online Members do not have access to local Chapter Presentations online.

Corporate Membership ($850) A great savings! Five members from one company at $170 each. Multiple locations accepted within the same company.

We cannot activate a corporate membership online. For more information, email info@webnetwork.org or call 1-888-795-6862.

Chapter

If there is no chapter in your community and you would like to form one, please contact WEB.

Select Chapter *

Payment Information

Click the "Submit Application" button once below to send us your application. You will receive a confirmation email.

If you wish to pay with a credit card, your membership will be activated immediately. To pay with a credit card, click the radio button to the left of one of these images: Amex, MasterCard or Visa.

If you wish to pay by mailing a check, your membership will be activated when payment is received. To choose the option to mail your payment, click the radio button to the left of the image "Check".

Mail your payment within 5 days to our NEW ADDRESS:

Worldwide Employee Benefits Network
11520 North Central Expressway, Suite 201
Dallas TX 75243

Total:

Payment Method: *

Card Holder Name: *

Credit Card Number: *

Expiration Date: *

Do not click the button more than once or your credit card may be charged more than once.

Join Worldwide Employee Benefits Network Today!

Save with a Corporate Membership: Enroll five members from the same organization and the membership rate is reduced to $170 each. Members do not have to be in the same chapter. This is a savings of $150 over five Individual memberships. A Corporate Membership cannot be processed online.

To apply for a Corporate Membership or if you have got any questions, please Email WEB at info@webnetwork.org or Call 888-795-6862

Get to know the benefits of WEB Membership

Type of Membership (per person)	Membership Rates
Individual Membership — 1 Year	$250
Individual Membership — 2 Years	$450 Save $50!
Associate Membership — 1 Year Discounted Associate memberships apply if you are employed by a government/not-for-profit entity, in transition, retired, outside of our current chapter areas, or a full-time student	$150
Corporate Membership (for 5 people) Enroll five members from the same organization and the membership rate is reduced to $200 each. Members do not have to be in the same chapter. This is a savings of $250 over five Individual memberships. A Corporate Membership cannot be processed online. Email WEB at info@webnetwork.org or call 888-795-6862 to apply for a Corporate Membership. Any questions contact WEB at info@webnetwork.org or 888-795-6862.	Great Savings! $1000 for five members ($200 each) from the same organization - even if located in different cities!